scholarly journals 3D-printed moulds facilitate making an anatomically matched cement spacer for reconstruction long bone defection after resection of tumors of humerous

2018 ◽  
Vol 2 (1) ◽  
pp. 27-31
Author(s):  
Haltao Zhao ◽  
Arun Sigdel ◽  
Xizhi Hou ◽  
Ting Zhang ◽  
Guochuan Zhang ◽  
...  
Keyword(s):  
Proximal Humerus ◽  
Tumor Resection ◽  
Mirror Image ◽  
Long Bone ◽  
Wide Resection ◽  
Cement Spacer ◽  
3D Printed ◽  
Ct Data ◽  
Neo Adjuvant Chemotherapy ◽  
The Right

Background: A nail and cement spacer is one of the option for the reconstruction of the proximal humerus after tumor resection among prosthesis unaffordable patients. However, making the cement spacer anatomically match its replacement remains challenging. Presentation of case: A 12-year-old boy was diagnosed with osteosarcoma in the right proximal humerus by core needle biopsy. After preoperative neo-adjuvant chemotherapy, a wide resection was performed, and the defect was reconstructed with an anatomically matched cement spacer. The cement spacer was fabricated using 3D-printed moulds, which were made according to the mirror image of the left humerus based on CT data. The post-operative course was uneventful, and at the 12-month follow-up, the patient is able to move with only some restriction in abduction and upward lift. The MSTD score was 21. Conclusion: Fabrication of an anatomically matched cement spacer using 3D-printed moulds is a simple, inexpensive, and reproducible procedure for reconstruction complex bone defect.

scholarly journals Proximal Humerus Reconstruction after Tumor Resection: An Overview of Surgical Management

2021 ◽  
Vol 2021 ◽  
pp. 1-16
Author(s):  
Antonio D’Arienzo ◽  
Edoardo Ipponi ◽  
Alfio Damiano Ruinato ◽  
Silvia De Franco ◽  
Simone Colangeli ◽  
...  
Keyword(s):  
Proximal Humerus ◽  
Malignant Tumors ◽  
Therapeutic Option ◽  
Tumor Resection ◽  
Wide Resection ◽  
First Line ◽  
Oncologic Surgery ◽  
Advantages And Disadvantages ◽  
Oncological Patients ◽  
Surgical Options

Proximal humerus is one of the anatomical sites that are most frequently involved by bone and soft tissue malignant tumors. Alone or in association with adjuvant treatments, surgery represents the main therapeutic option to treat and eradicate these diseases. Once the first-line option, in the last decades, amputation lost its role as treatment of choice for the large majority of cases in favor of the modern limb sparing surgery that promises to preserve anatomy and—as much as possible—upper limb functionality. Currently, the main approaches used to replace proximal humerus after a wide resection in oncologic surgery can be summarized in biological reconstructions (allografts and autografts), prosthetic reconstructions (anatomic endoprostheses, total reverse shoulder prostheses), and graft-prosthetic composite reconstructions. The purpose of this overview is to present nowadays surgical options for proximal humerus reconstruction in oncological patients, with their respective advantages and disadvantages.

scholarly journals Total femur replacement for Ewing’s sarcoma after wide resection of the proximal femur: a long-term follow-up case study

2011 ◽  
Vol 5 (1) ◽  
pp. 119-122
Author(s):  
Yukihiro Yoshida ◽  
Shunzo Osaka ◽  
Yasuaki Tokuhashi
Keyword(s):  
Ewing’S Sarcoma ◽  
Ewing's Sarcoma ◽  
Tumor Resection ◽  
Wide Resection ◽  
Long Term Follow Up ◽  
And Migration ◽  
The Right

Abstract Background: Total femur replacement is a relatively rarely performed procedure for the reconstruction of an affected limb after resection of a malignant bone tumor. Objective: Report total femur replacement in a 17-year-old male patient after wide resection of the right femur for involvement of the proximal segment of the bone by Ewing’s sarcoma. Results: The complications that often arose from the use of the tumor prostheses after the tumor resection, e.g., infection and migration/dislocation of the artificial bonehead, were overcome successfully. The patient has been under follow-up for a relatively long period of time (16 years) since the surgery. The operated limb function is now rated at 70% according to the rating system by Musculo-Skeletal Tumor Society (MSTS). The patient has almost completely regained his ability to walk and carries on with activities of daily living. Conclusion: If appropriate measures are taken to deal with the complications, favorable function of the operated limb can be expected to be maintained for long periods after reconstruction using this technique.

scholarly journals 3D-Printed Titanium Custom-Made Prostheses in Reconstruction after Pelvic Tumor Resection: Indications and Results in a Series of 14 Patients at 42 Months of Average Follow-Up

2021 ◽  
Vol 10 (16) ◽  
pp. 3539
Author(s):  
Carmine Zoccali ◽  
Jacopo Baldi ◽  
Dario Attala ◽  
Alessandra Scotto di Uccio ◽  
Luca Cannavò ◽  
...  
Keyword(s):  
Tumor Resection ◽  
Long Term Results ◽  
Wide Resection ◽  
Primary Bone Tumors ◽  
Spine Stabilization ◽  
Custom Made ◽  
Prosthesis Removal ◽  
3D Printed ◽  
Primary Bone ◽  
Custom Made Prostheses

Wide resection is currently considered the mainstay treatment for primary bone tumors. When the tumor is located in anatomically complex segments, 3D-Printed Titanium Custom-Made Prostheses (3DPTCMP) are possible reconstructive solutions. The aim of the present paper is to analyze indications, results and complications of a series of 14 patients who underwent pelvis reconstruction with 3DPTCMP after tumor removal from January 2015 to December 2019. Chondrosarcoma was the main histology; indications were tumors located in the acetabular area without enough residual bone to support a cup with an iliac stem, and tumors located near the sacrum-iliac joint. The margins were wide in 12 cases, and marginal and intralesional in one case each. In three cases, resection also included the sacrum-iliac joint, so a spine stabilization was performed and linked to the pelvic prosthesis; The average MSTS score was 46.3%; the 5-year local recurrence-free survival was 85.7%. Wound dehiscences were the main complication, resolved with multiple debridements; nevertheless, prosthesis removal was necessary in one case. Currently, the 3DPTCMP is an effective resource for reconstruction after resection of tumors located in the pelvis. Further studies are necessary to value long-term results; more strategies are necessary to try to reduce the infection rate and improve osteointegration.

scholarly journals Infected nonunion proximal humerus fracture: two-stage oncologic approach solution with reverse total shoulder reconstruction

2016 ◽  
Vol 15 (1) ◽  
Author(s):  
Khairul Nizam Siron ◽  
Goh Kian Liang ◽  
Mohd Ariff Sharifuddin ◽  
Ed Simor Khan Mor Japar Khan ◽  
Mohd Shahidan Nor Rahin ◽  
...  
Keyword(s):  
Proximal Humerus ◽  
Wide Resection ◽  
Cement Spacer ◽  
Two Stage ◽  
Infected Nonunion ◽  
Non Union ◽  
Eradication Of Infection ◽  
Staged Approach ◽  
Reverse Shoulder Replacement ◽  
Reverse Total Shoulder

Introduction: Infected non-union of proximal humerus after fixation is devastating consequence and remains challenging. Methods: The staged oncologic approach consists of wide resection and reconstruction ensures remissions of the infection. Results: We report a case of two-stage oncologic approach in a patient with infected non-union proximal humerus after fixation. In the first stage we have performed a wide resection and antibiotic cement spacer insertion. After complete eradication of infection, subsequent reconstruction of the shoulder using reverse shoulder replacement with modular humeral stem had been performed on purpose of restoring the acceptable joint functions. Conclusions: Reconstruction of the infected non-union of the proximal humerus is a challenging task, costly procedure that requires the use of the sophisticated limb reconstruction system. Staged approach incorporating the use oncologic wide resection to eradicate the infection with subsequent bony reconstruction ensure the optimum restoration of upper limb functions.

A 3D-Printed Model-Assisted Cervical Spine Instrumentation after Tumor Resection in a 4-Year-Old Child: A Case Report

2021 ◽  
pp. 1-7
Author(s):  
Marko Jug
Keyword(s):  
Cervical Spine ◽  
3D Model ◽  
Intraoperative Complications ◽  
Tumor Resection ◽  
Upper Cervical Spine ◽  
Spine Instrumentation ◽  
Cord Injury ◽  
Spinal Navigation ◽  
Upper Cervical ◽  
3D Printed

<b><i>Introduction:</i></b> In the case of tumor resection in the upper cervical spine, a multilevel laminectomy with instrumented fixation is required to prevent kyphotic deformity and myelopathy. Nevertheless, instrumentation of the cervical spine in children under the age of 8 years is challenging due to anatomical considerations and unavailability of specific instrumentation. <b><i>Case Presentation:</i></b> We present a case of 3D-printed model-assisted cervical spine instrumentation in a 4-year-old child with post-laminectomy kyphotic decompensation of the cervical spine and spinal cord injury 1 year after medulloblastoma metastasis resection in the upper cervical spine. Due to unavailability of specific instrumentation, 3D virtual planning was used to assess and plan posterior cervical fixation. Fixation with 3.5 mm lateral mass and isthmic screws was suggested and the feasibility of fixation was confirmed “in vitro” in a 3D-printed model preoperatively to reduce the possibility of intraoperative implant-spine mismatch. Intraoperative conditions completely resembled the preoperative plan and 3.5 mm polyaxial screws were successfully used as planned. Postoperatively the child made a complete neurological recovery and 2 years after the instrumented fusion is still disease free with no signs of spinal decompensation. <b><i>Discussion/Conclusion:</i></b> Our case shows that posterior cervical fixation with the conventional screw-rod technique in a 4-year-old child is feasible, but we suggest that suitability and positioning of the chosen implants are preoperatively assessed in a printed 3D model. In addition, a printed 3D model offers the possibility to better visualize and sense spinal anatomy “in vivo,” thereby helping screw placement and reducing the chance for intraoperative complications, especially in the absence of intraoperative spinal navigation.

scholarly journals RONC-26. A CASE OF RADIATION NECROSIS OF THE CEREBELLUM 16 YEARS AFTER CHEMORADIOTHERAPY FOR MEDULLOBLASTOMA

2020 ◽  
Vol 22 (Supplement_3) ◽  
pp. iii460-iii460
Author(s):  
Mayuko Miyata ◽  
Masahiro Nonaka ◽  
Akio Asai
Keyword(s):  
Radiation Necrosis ◽  
Tumor Resection ◽  
Pathological Examination ◽  
Secondary Cancer ◽  
Brain Necrosis ◽  
Cerebellar Medulloblastoma ◽  
Cerebellar Peduncle ◽  
The Right ◽  
The Brain

Abstract BACKGROUND If new lesions are observed during follow-up of the malignant tumor after treatment, it is difficult to distinguish whether the tumor is a recurrent lesion, secondary cancer, or radiation necrosis of the brain. We have encountered a patient with symptomatic radiation necrosis of the cerebellum 16 years after treatment of medulloblastoma. CASE PRESENTATION: A 24-year-old man who had received a tumor resection and chemoradiotherapy for cerebellar medulloblastoma at the age of 8 presented with dizziness. For the past 16 years, there was no recurrence of the tumor. He subsequently underwent MRI scan, and T1-Gd image showed enhanced lesion in the right cerebellar peduncle. Cerebrospinal fluid cytology analysis was negative for tumor. We suspected tumor reccurence or secondary cancer, and performed lesion biopsy. The result of the pathological examination was radiation necrosis of the cerebellum. DISCUSSION: The interval of radiation necrosis of the brain and radiotherapy can vary from months to more than 10 years. So, whenever a new lesion is identified, radiation brain necrosis must be envisioned. According to guidelines in Japan, there is no absolute examination for discriminating tumor recurrence from radiation brain necrosis and diagnosis by biopsy may be required. CONCLUSION We experienced a case of symptomatic radiation necrosis of the cerebellum 16 years after treatment. In patients showing new lesion after long periods of time, the possibility of radiation necrosis to be considered.

scholarly journals Clinical study of 3D printed personalized prosthesis in the treatment of bone defect after pelvic tumor resection

2021 ◽  
Vol 29 ◽  
pp. 163-169
Author(s):  
Lin Xu ◽  
Hao Qin ◽  
Jia Tan ◽  
Zhilin Cheng ◽  
Xiang Luo ◽  
...  
Keyword(s):  
Clinical Study ◽  
Bone Defect ◽  
Tumor Resection ◽  
Pelvic Tumor ◽  
3D Printed

scholarly journals Hyperthermia in a pediatric patient with neuroblastoma during anesthesia: a case report

BMC Surgery ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Chuan Wang ◽  
Wenqiong Xin ◽  
Yi Ji
Keyword(s):  
Tumor Resection ◽  
Neuron Specific Enolase ◽  
Tracheal Extubation ◽  
Posterior Mediastinum ◽  
Gas Analysis ◽  
Vanillylmandelic Acid ◽  
Management Options ◽  
Paravertebral Space ◽  
Tissue Mass ◽  
The Right

Abstract Background Neuroblastoma is the most common malignant extracranial solid tumor in pediatrics patients. Intraoperative hyperthermia is extremely rare in patients with neuroblastoma and can cause a series of complications. Here, we represent a case of neuroblastoma accompanied by hyperthermia during anesthesia, and propose a rational explanation and management options. Case presentation The patient had gait disturbance and sitting-related pain without fever. Magnetic resonance imaging revealed a soft tissue mass located in the right posterior mediastinum, paravertebral space and canalis vertebralis. Serum tumor marker screening showed that the patient had increased epinephrine, norepinephrine and neuron specific enolase levels, with an increased 24 hour urine vanillylmandelic acid level. Intraspinal tumor resection was conducted. The temperature of the patient rapidly arose to 40.1 °C over 10 minutes when waiting for tracheal extubation. The arterial gas analysis results indicated malignant hyperthermia was less likely, and dantrolene was not administered. Physical cooling methods were used, and the temperature dropped to 38.6 ℃. The trachea was successfully extubated. Histological results confirmed the diagnosis of neuroblastoma. Conclusions Hyperthermia during anesthesia is a serious adverse event. Catecholamines secreted from neuroblatoma cells can lead to hypermetabolism and hyperthermia. Surgeons and anesthesiologists should be aware of the possibility of hyperthermia in patients with neuroblastoma.

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