Alaseem Abdulrahman, Alsanawi Hisham A, Albishi Waleed, Alshaygy Ibrahim, Alhomaidhi Sara, Almashouq Mohammad K, AlSudairi Abdulaziz M, Alsehibani Yazeed A, Almuhanna Abdulaziz O
Department of Orthopedic Surgery, College of Medicine, King Saud University, Riyadh 1211, Saudi Arabia.
College of Medicine, King Saud University, Riyadh 1211, Saudi Arabia.
Curr Oncol. 2025 Jul 22;32(8):411. doi: 10.3390/curroncol32080411.
Osteosarcoma is one of the most common primary bone malignancies, typically occurring around the knee. However, the forearm is a rare site, with tumors in the proximal ulna being extremely uncommon. Primary sarcoma in this location presents a surgical challenge due to the complex anatomy and limited reconstructive options. We report a rare case of a 19-year-old female with non-metastatic, high-grade giant cell-rich osteosarcoma involving the right proximal ulna. To our knowledge, this is only the second reported adult case of this histological subtype in this location. The patient was treated at a specialized oncology center with neoadjuvant and adjuvant chemotherapy, along with wide intra-articular resection for local tumor control. Reconstruction was achieved using a novel, customized 3D-printed articulating cement spacer mold with plate osteosynthesis. Artificial elbow ligamentous reconstruction was performed using FiberTape and FiberWire sutures passed through drill holes, and the triceps tendon was reattached to the cement mold using an endobutton. This cost-effective and personalized surgical approach allowed successful joint reconstruction while maintaining elbow stability and function. Our case highlights a feasible reconstructive option for rare and anatomically challenging osteosarcoma presentations, contributing to the limited literature on proximal ulna giant cell-rich osteosarcoma.
骨肉瘤是最常见的原发性骨恶性肿瘤之一，通常发生在膝关节周围。然而，前臂是一个罕见的发病部位，近端尺骨发生肿瘤极为少见。由于该部位解剖结构复杂且重建选择有限，此处的原发性肉瘤带来了手术挑战。我们报告了一例罕见病例，一名19岁女性患有非转移性、高级别富含巨细胞的骨肉瘤，累及右近端尺骨。据我们所知，这是该部位此组织学亚型第二例报告的成人病例。该患者在一家专业肿瘤中心接受了新辅助化疗和辅助化疗，以及为控制局部肿瘤进行的广泛关节内切除术。使用新型定制的3D打印可活动骨水泥间隔物模具及钢板骨固定术实现了重建。通过钻孔使用FiberTape和FiberWire缝线进行人工肘关节韧带重建，并用纽扣将肱三头肌腱重新附着于骨水泥模具上。这种经济高效且个性化的手术方法成功实现了关节重建，同时保持了肘关节的稳定性和功能。我们的病例突出了一种针对罕见且解剖结构具有挑战性的骨肉瘤表现的可行重建选择，为关于近端尺骨富含巨细胞骨肉瘤的有限文献做出了贡献。
