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一名患有尤因肉瘤的儿科患者的股骨近端异体假体:病例报告。

Proximal femur alloprosthesis in a pediatric patient with Ewing sarcoma: Case report.

作者信息

Soto Camilo, Betancur Andrea, Arroyave Sergio, Coronado David, Trilleras Estefanny

机构信息

Orthopedic oncologist, Misericordia Pediatric Hospital Foundation, Bogotá, Colombia.

UNAB Orthopedics and traumatology resident, Floridablanca, Colombia; UNAL Orthopedics and Traumatology Resident, Bogotá, Colombia.

出版信息

Int J Surg Case Rep. 2024 Jul;120:109815. doi: 10.1016/j.ijscr.2024.109815. Epub 2024 May 29.

Abstract

INTRODUCTION AND IMPORTANCE

Ewing sarcoma is a primary malignant tumor of bone and, to a lesser extent, soft tissues. Within oncological management, surgery with extensive local control and reconstruction is the most accepted option, however, the size, extension of the tumor, the age of the patient and distant involvement can make this option difficult.

CASE PRESENTATION

We present a clinical case of a 3-year-old infant with Ewing sarcoma in the proximal femur, who was managed with wide resection of the tumor plus proximal humerus allograft, which acted as a proximal femur for 2 years and then presented joint failure due to what was done was the application of a cemented stem over the remnant of the allograft to save the hip.

CLINICAL DISCUSSION

In the presented case, similar to the report by Zoccali a malignant tumor in the proximal femur of a pediatric patient is documented. In these cases, where the distal femoral growth plate is disease-free, a reconstruction technique preserving the growth plate is proposed.

CONCLUSION

The technique of proximal femoral allograft with a proximal humeral graft is an acceptable reconstructive treatment alternative for young patients with Ewing sarcoma, especially when conventional treatment options are limited. This approach helps avoid limb-threatening surgeries such as amputation or rotationplasty, providing a viable and functional solution for limb salvage in these cases.

摘要

引言与重要性

尤因肉瘤是一种主要发生于骨骼的原发性恶性肿瘤,较少发生于软组织。在肿瘤治疗中,进行广泛局部控制和重建的手术是最常采用的选择,然而,肿瘤的大小、范围、患者年龄以及远处转移情况可能会使这一选择变得困难。

病例介绍

我们呈现了一名3岁婴儿的临床病例,该婴儿股骨近端患有尤因肉瘤,接受了肿瘤广泛切除加肱骨近端同种异体骨移植治疗,该同种异体骨作为股骨近端发挥作用2年,之后由于在同种异体骨残余部分应用了骨水泥型假体柄以挽救髋关节而出现关节功能障碍。

临床讨论

在本病例中,与佐卡利的报告类似,记录了一名儿科患者股骨近端的恶性肿瘤。在这些病例中,若股骨远端生长板未受累,建议采用保留生长板的重建技术。

结论

肱骨近端移植的股骨近端同种异体骨技术是尤因肉瘤年轻患者可接受的重建治疗选择,尤其是在传统治疗选择有限时。这种方法有助于避免截肢或旋转成形术等威胁肢体的手术,为这些病例的肢体挽救提供可行且功能良好的解决方案。

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