Harvey Michael J, Rosenthal Howard G
University of Missouri Kansas City School of Medicine, Kansas City, MO, USA.
University of Kansas, Sarcoma Center, Overland Park, KS, USA.
Case Rep Oncol Med. 2021 Jan 25;2021:1968621. doi: 10.1155/2021/1968621. eCollection 2021.
Malignant musculoskeletal tumors about the shoulder girdle region involving the scapula are fairly rare, but when diagnosed, challenging and complex surgical treatment may be warranted with the primary goal of improving patient survival. These tumors are typically extensive and infiltrative at the time of presentation, requiring radical resection to achieve margins and obtain local tumor control. Historically, forequarter amputation or flail extremity were the mainstays of treatment in these cases. Presently, with recent advances in diagnostics, imaging, adjuvant therapies, and surgical treatment, many patients presenting with malignant tumors involving the scapula are candidates for limb salvage surgery. Reconstruction with endoprosthesis seems to have gained acceptance as the preferred surgical treatment for such lesions, as this intervention has resulted in improved postoperative function and cosmesis, with an acceptable complication rate. We present our experience with recent advancement in these surgical efforts in the form of shoulder girdle reconstruction with total scapular reverse total shoulder prosthesis after radical tumor excision.
累及肩胛骨的肩胛带区域恶性肌肉骨骼肿瘤相当罕见,但一旦确诊,可能需要进行具有挑战性且复杂的手术治疗,其主要目标是提高患者生存率。这些肿瘤在就诊时通常范围广泛且具有浸润性,需要进行根治性切除以达到切缘并实现局部肿瘤控制。从历史上看,前半侧截肢或连枷肢体是这些病例的主要治疗方法。目前,随着诊断、成像、辅助治疗和手术治疗的最新进展,许多出现累及肩胛骨恶性肿瘤的患者成为保肢手术的候选者。使用假体进行重建似乎已被公认为此类病变的首选手术治疗方法,因为这种干预已导致术后功能和美观得到改善,且并发症发生率可接受。我们以根治性肿瘤切除后使用全肩胛骨反向全肩关节假体进行肩胛带重建的形式,介绍我们在这些手术方面的最新进展经验。