Wehbe Hussein, Nassar Hassan, Sweidan Ihab, Awwad Aya, Saghieh Said
Department of Orthopaedics and Traumatology, Lebanese University Faculty of Medicine, Beirut, Lebanon.
Department of Orthopaedics and Traumatology, Adult Reconstruction, American University of Beirut, Lebanon.
J Orthop Case Rep. 2024 Sep;14(9):116-124. doi: 10.13107/jocr.2024.v14.i09.4750.
The incidence of chondrosarcomas is relatively high as it comes second to multiple myeloma as the most common primary malignant bony neoplasms in adults. They tend to occur mostly in the axial skeleton. Hence, they rarely develop in the proximal humerus. Although imaging can aid in the diagnosis of chondrosarcoma, histopathology is the cornerstone that correlates with prognosis and guides us toward the most appropriate treatment modality. Surgical treatment is the best option for chondrosarcomas as most of them are resistant to chemotherapy and radiotherapy. It is really challenging to settle on one surgical technique for proximal humerus chondrosarcomas as surgeons must balance between saving the patient from the oncological process and maintaining a good function of the shoulder joint.
We present herein a rare case, the first in Lebanon, of chondrosarcoma hitting the left proximal humerus of a 62-year-old lady successfully managed by operative resection and reconstruction with a cemented shoulder hemiarthroplasty using the Modular Universal Tumor and Revision System (MUTARS®) system.
Chondrosarcomas are relatively rare. Their resistance to chemotherapy and radiation therapy in addition to their proximal humerus localization is troublesome for both the patient and the surgeon. Hence, a relatively new technique (first in Lebanon and the Middle East), the MUTARS shoulder hemiarthroplasty is found to have promising results on terms of morbidity and mortality for the patient when indicated and properly done.
软骨肉瘤的发病率相对较高,在成人原发性恶性骨肿瘤中仅次于多发性骨髓瘤,位居第二。它们大多倾向于发生在中轴骨骼。因此,在肱骨近端很少发生。尽管影像学有助于软骨肉瘤的诊断,但组织病理学是与预后相关并指导我们选择最合适治疗方式的基石。手术治疗是软骨肉瘤的最佳选择,因为大多数软骨肉瘤对化疗和放疗耐药。对于肱骨近端软骨肉瘤,确定一种手术技术极具挑战性,因为外科医生必须在使患者摆脱肿瘤进程和维持肩关节良好功能之间取得平衡。
我们在此呈现一例罕见病例,这是黎巴嫩首例,一名62岁女性左肱骨近端发生软骨肉瘤,通过使用模块化通用肿瘤与翻修系统(MUTARS®)进行骨水泥型半肩关节置换术的手术切除和重建成功治疗。
软骨肉瘤相对罕见。它们对化疗和放疗的耐药性以及在肱骨近端的定位,对患者和外科医生来说都很棘手。因此,一种相对较新的技术(黎巴嫩和中东地区首例),即MUTARS半肩关节置换术,在适应证明确且操作得当的情况下,对患者的发病率和死亡率而言,已显示出有前景的结果。