Treatment and outcome of malignant bone tumors of the proximal humerus: biological versus endoprosthetic reconstruction

Background: The management of malignant bone tumors in children has come a long way in the past few decades. The transition from amputation to limb salvage has been made possible due to the rapid development in the diagnosis and the oncological management of these malignant tumors. However, there exist significant reservations regarding endoprosthetic reconstruction in children. Material and methods: A mini-review was conducted of articles detailing the use of prosthetic reconstruction following tumor resection in children. The data regarding complications and functional outcomes following surgery were collected and presented. Results: The studies reviewed reported a 5-year survival rate between 60 – 70 %. Uniform across the studies was the need for multiple surgeries when endoprosthesis was used for limb reconstruction, ranging between 2.8 – 3.5 surgeries. The most common complication noted across the studies was related to soft tissue problems such as joint instability followed by structural failure of the prosthesis. Infections were noted with a frequency of 10 – 15 %. Studies showed successful management of limb length discrepancy with expandible prosthesis. Musculoskeletal Tumor Society (MSTS) score used to evaluate the functional outcome showed satisfactory outcomes. Conclusion: Limb salvage surgery, with recent advances in technique and prosthesis design, is an attractive option in children with extremity malignant bone tumors. In recent time, endoprosthetic reconstruction of extremities have yielded good functional results and are well accepted by the child and the parents. The purpose of this mini-review is to shed some light on the use of endoprosthetic reconstruction in children following tumor resection with its potential benefits and drawbacks.

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A Massive Chondroblastoma in the Proximal Humerus Simulating Malignant Bone Tumors

Case Reports in Orthopedics ◽

10.1155/2013/673576 ◽

2013 ◽

Vol 2013 ◽

pp. 1-5 ◽

Cited By ~ 1

Author(s):

Ichiro Tonogai ◽

Mitsuhiko Takahashi ◽

Hiroaki Manabe ◽

Toshihiko Nishisho ◽

Seiji Iwamoto ◽

...

Keyword(s):

Bone Tumors ◽

Proximal Humerus ◽

Histopathological Examination ◽

Extreme Case ◽

Transcatheter Embolization ◽

Bone Neoplasm ◽

Lytic Lesion ◽

Reconstructive Procedure ◽

Malignant Bone Tumors ◽

Local Destruction

Chondroblastoma is a mostly benign bone neoplasm that typically affects the second decade of life and exhibits a lytic lesion in the epiphysis of long bones. We report an extreme case of massive, destructive chondroblastoma of the proximal humerus in a 9-year-old girl. It was difficult to differentiate using imaging information the lesion from malignant bone tumors such as osteosarcoma. Histopathological examination from biopsy proved chondroblastoma. The tumor was resected after preoperative transcatheter embolization. Reconstructive procedure for the proximal humerus was not performed due to the local destruction. The present case demonstrates clinical and radiological differentiations of the massive chondroblastoma from the other lesions and histopathological understandings for this lesion.

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Feasibility Analysis and Clinical Applicability of a Modified Type V Resection Method for Malignant Bone Tumors of the Proximal Humerus

Journal of Investigative Surgery ◽

10.1080/08941939.2018.1483445 ◽

2018 ◽

Vol 33 (2) ◽

pp. 191-197

Author(s):

Qing Liu ◽

Zhibing Dai ◽

Junshen Wu ◽

Suzhi Ji ◽

Jingping Bai ◽

...

Keyword(s):

Bone Tumors ◽

Proximal Humerus ◽

Feasibility Analysis ◽

Malignant Bone Tumors ◽

Clinical Applicability ◽

Type V

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Modular Endoprosthetic Reconstruction in Malignant Bone Tumors: Indications and Limits

Treatment of Bone and Soft Tissue Sarcomas - Recent Results in Cancer Research ◽

10.1007/978-3-540-77960-5_4 ◽

2009 ◽

pp. 39-50 ◽

Cited By ~ 15

Author(s):

Maurice Balke ◽

Helmut Ahrens ◽

Arne Streitbürger ◽

Georg Gosheger ◽

Jendrik Hardes

Keyword(s):

Bone Tumors ◽

Endoprosthetic Reconstruction ◽

Malignant Bone Tumors

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Limb salvage operation of the malignant bone tumors of the proximal humerus.

Orthopedics & Traumatology ◽

10.5035/nishiseisai.38.824 ◽

1989 ◽

Vol 38 (2) ◽

pp. 824-826

Author(s):

Ayumu Terada ◽

Takashi Sakou ◽

Shunji Matsunaga ◽

Hiroshi Itou ◽

Shinji Tanaka ◽

...

Keyword(s):

Limb Salvage ◽

Bone Tumors ◽

Proximal Humerus ◽

Malignant Bone Tumors ◽

Salvage Operation

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Endoprosthetic Reconstruction in the Limb Salvage Surgery for Treatment of Malignant Bone Tumors

The Journal of the Korean Orthopaedic Association ◽

10.4055/jkoa.2015.50.6.453 ◽

2015 ◽

Vol 50 (6) ◽

pp. 453

Author(s):

Han-Soo Kim

Keyword(s):

Limb Salvage ◽

Bone Tumors ◽

Salvage Surgery ◽

Limb Salvage Surgery ◽

Endoprosthetic Reconstruction ◽

Malignant Bone Tumors

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Scintigraphy with 99m Tc-Phosphonate and 67Gallium in Patients Suspected of Primary Bone Tumors

Nuklearmedizin ◽

10.1055/s-0037-1620567 ◽

1982 ◽

Vol 21 (04) ◽

pp. 136-139 ◽

Cited By ~ 2

Author(s):

C.-J. Edeling

Keyword(s):

Soft Tissue ◽

Bone Scintigraphy ◽

Primary Tumor ◽

Bone Tumors ◽

Whole Body ◽

Skeletal Metastases ◽

Malignant Bone Tumors ◽

67Ga Scintigraphy ◽

Primary Bone Tumors ◽

Primary Bone

Whole-body scintigraphy with both 99mTc-phosphonate and 67Ga was performed on 92 patients suspected of primary bone tumors. In 46 patients with primary malignant bone tumors, scintigraphy with 99mTc-phosphonate disclosed the primary tumor in 44 cases and skeletal metastases in 11, and 67Ga scintigraphy detected the primary tumor in 43 cases, skeletal metastases in 6 cases and soft-tissue metastases in 8 cases. In 25 patients with secondary malignant bone tumors, bone scintigraphy visualized a single lesion in 10 cases and several lesions in 15 cases, and 67Ga scintigraphy detected the primary tumor in 17 cases, skeletal metastases in 17 cases and soft-tissue metastases in 9 cases. In 21 patients with benign bone disease positive uptake of 99mTc-phosphonate was recognized in 19 cases and uptake of 67Ga in 17 cases. It is concluded that bone scintigraphy should be used in patients suspected of primary bone tumors. If malignancy is suspected, 67Ga scintigraphy should be performed in addition.

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