Afacan Muhammed Yusuf, Celayir Arın, Elibollar Cansu, Ozsahin Mahmut K, Botanlioglu Huseyin
Department of Orthopaedics and Traumatology, Istanbul University-Cerrahpasa, Cerrahpasa Faculty of Medicine, Istanbul, TUR.
Cureus. 2025 May 16;17(5):e84261. doi: 10.7759/cureus.84261. eCollection 2025 May.
Osteosarcoma of the proximal humerus presents significant challenges due to the proximity of critical neurovascular structures. This case report describes the management of an eight-year-old male diagnosed with high-grade intramedullary osteosarcoma of the proximal humerus with axillary lymph node involvement. Following neoadjuvant chemotherapy, the patient underwent wide resection, axillary lymph node dissection, and reconstruction using a proximal humerus anatomical mega prosthesis, followed by adjuvant chemotherapy. Radiotherapy was not required. Early postoperative range of motion was considerably good, with satisfactory shoulder and elbow function achieved. At the 1.5-year follow-up, there was no evidence of local recurrence or metastasis, and the prosthesis remained stable. This report demonstrates that limb-sparing surgery with prosthetic reconstruction offers favorable oncological and functional outcomes and may represent a preferable alternative to vascularized fibula grafting in pediatric patients with proximal humeral osteosarcoma.
由于关键神经血管结构位置临近，肱骨近端骨肉瘤的治疗面临重大挑战。本病例报告描述了一名8岁男性的治疗过程，该患者被诊断为肱骨近端高级别髓内骨肉瘤并伴有腋窝淋巴结受累。在新辅助化疗后，患者接受了广泛切除、腋窝淋巴结清扫，并使用肱骨近端解剖型大型假体进行重建，随后进行辅助化疗。无需放疗。术后早期活动范围相当良好，肩部和肘部功能令人满意。在1.5年的随访中，没有局部复发或转移的迹象，假体保持稳定。本报告表明，保肢手术联合假体重建可带来良好的肿瘤学和功能结果，对于患有肱骨近端骨肉瘤的儿科患者而言，可能是血管化腓骨移植的一种更优选择。
