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锁骨远端尤因肉瘤的综合管理:一个突出手术切除、肿瘤学挑战及康复结果的病例

Comprehensive Management of Distal Clavicle Ewing's Sarcoma: A Case Highlighting Surgical Resection, Oncologic Challenges, and Rehabilitation Outcomes.

作者信息

Alqahtani Taif, Alfadil Sara, AlRawi Mustafa, AlAbbasi Khaled, Alshaya Osama

机构信息

Orthopedic Surgery, Ministry of Health, Riyadh, SAU.

Executive Medical Administration, King Fahad Medical City, Riyadh, SAU.

出版信息

Cureus. 2024 Aug 14;16(8):e66901. doi: 10.7759/cureus.66901. eCollection 2024 Aug.

Abstract

This case report presents an unusual manifestation of Ewing's Sarcoma (EwS) in the distal clavicle of a 32-year-old male. The patient's journey began with an initial misdiagnosis of a shoulder mass as a benign condition, but advanced imaging techniques later uncovered the malignant nature of the lesion. Emphasizing the complexities of managing EwS in atypical locations and in adult patients, this report details the implementation of a neo-adjuvant chemotherapy regimen. The chemotherapy aimed to reduce tumor size and mitigate the spread, preparing for a more effective surgical resection. The subsequent surgical strategy involved a meticulous resection of the distal clavicle, focusing on achieving clear margins while preserving the functional integrity of the shoulder, crucial for the patient's profession. The postoperative phase was marked by a comprehensive rehabilitation program, crucial for recovery and return to occupational activities. This case underscores the importance of early and accurate diagnosis, the effectiveness of a preoperative chemotherapy strategy, and the need for a multidisciplinary approach, including oncological treatment, surgical precision, and rehabilitative care.

摘要

本病例报告介绍了一名32岁男性患者锁骨远端尤文肉瘤(EwS)的罕见表现。患者最初被误诊为肩部肿块为良性疾病,但先进的成像技术后来发现了病变的恶性性质。本报告强调了在非典型部位和成年患者中管理EwS的复杂性,详细介绍了新辅助化疗方案的实施情况。化疗旨在缩小肿瘤大小并减轻扩散,为更有效的手术切除做准备。随后的手术策略包括对锁骨远端进行细致切除,重点是在保留肩部功能完整性的同时实现切缘阴性,这对患者的职业至关重要。术后阶段以全面的康复计划为标志,这对恢复和重返职业活动至关重要。本病例强调了早期准确诊断的重要性、术前化疗策略的有效性以及多学科方法的必要性,包括肿瘤治疗、手术精准性和康复护理。

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