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.

CRYOSURGERY IN THE TREATMENT OF PATIENTS WITH BONE TUMORS

2019 ◽  
Vol 65 (2) ◽  
pp. 165-171
Author(s):  
Aleksey Belyaev ◽  
Georgiy Prokhorov ◽  
Anna Arkhitskaya
Keyword(s):  
Liquid Nitrogen ◽  
Bone Tumors ◽  
Cryogenic Treatment ◽  
Long Term Results ◽  
Bone Lesions ◽  
Giant Cell Tumors ◽  
Primary Bone Tumors ◽  
Circulation Circuit ◽  
Recent Emergence ◽  
Primary Bone

A review of the literature shows that surgical procedures will remain the standard treatment for primary bone tumors. Analysis of studies on the assessment of long-term results shows that additional double cryogenic treatment of the curettage cavity can improve the treatment outcomes of patients with giant cell tumors, dysplastic diseases and some forms of malignant lesions. The traditional execution of the procedure is associated with the open installation of liquid nitrogen in the bone cavity, which requires special skills in handling aggressive refrigerant from the staff and does not exclude complications. In case of multiple metastatic bone lesions, surgical treatment is not indicated. The recent emergence in clinical practice of new equipment with a closed liquid nitrogen circulation circuit inside cryoprobes resumes interest in cryoabla-tion of bone tumor lesions using modern minimally invasive puncture cryotechnology and expanding indications for its use in patients with severe comorbidities.

Total ulna replacement with a 3D-printed custom-made prosthesis after en bloc tumor resection: A case report

2018 ◽  
Vol 66 (2) ◽  
pp. e27522 ◽  
Author(s):  
Xiang Fang ◽  
Wenli Zhang ◽  
Zeping Yu ◽  
Hongyuan Liu ◽  
Yan Xiong ◽  
...  
Keyword(s):  
Case Report ◽  
Tumor Resection ◽  
En Bloc ◽  
Custom Made ◽  
3D Printed

Distal Tibial Reconstruction in the Management of Primary Bone Tumors in Children and Adolescents

2021 ◽  
pp. 107110072110126
Author(s):  
Anna Raciborska ◽  
Katarzyna Bilska ◽  
Iwona Malesza ◽  
Carlos Rodriguez-Galindo ◽  
Bartosz Pachuta
Keyword(s):  
Bone Tumors ◽  
Radical Surgery ◽  
Plantar Flexion ◽  
Radical Resection ◽  
Limb Salvage Surgery ◽  
Level Of Evidence ◽  
Primary Bone Tumors ◽  
Custom Made ◽  
Primary Bone ◽  
Therapeutic Study

Background: Distal tibial primary bone tumors are rare, and options for limb salvage surgery are limited and challenging. Importantly, local control has shown to be crucial and necessary for cure, and radical surgery is one of the most important components of therapy for some bone sarcomas. We investigated the feasibility and functional and oncological outcomes of distal tibial reconstruction using endoprosthesis in children with malignant bone tumors. Methods: Fourteen patients (median age 13.6 years) with primary bone tumors (4 Ewing sarcoma [ES], 10 osteosarcoma) of the distal tibiae were treated during 2013-2019. All patients had reconstruction using a modular (13 patients) or expandable custom-made titanium bone replacement system (1 patient). All patients received chemotherapy before and after surgery. Results: Twelve patients (85.7%) are alive with a median follow-up 20 months from diagnosis. Five-year estimates of event-free survival and overall survival were 60.6% and 76.4%, respectively. Three patients had postoperative complications requiring second surgery. Maximum dorsiflexion and plantar flexion of the foot were 20 degrees (range 0-20 degrees) and 20 degrees (range 5-20 degrees), respectively. Conclusion: For select distal tibial sarcomas, after neoadjuvant chemotherapy pretreatment and radical resection, reconstruction using an endoprosthesis as a radical surgery provides an option was associated with a low rate of short-term local complications and relatively good early function. Level of Evidence: Level IV, therapeutic study.

scholarly journals A Giant Sacrococcygeal Chordoma: Case Report and Literature Review

2019 ◽  
Vol 7 (2) ◽  
pp. 60
Author(s):  
Xiang Yang ◽  
Seidu A. Richard ◽  
Wei Zhao ◽  
Jiagang Liu ◽  
Siqing Huang
Keyword(s):  
Tumor Resection ◽  
Immunohistochemical Analysis ◽  
Low Grade ◽  
Case Presentation ◽  
Primary Bone Tumors ◽  
Case Surgery ◽  
Primary Bone ◽  
Malignant Lesions ◽  
Magnetic Resonance Imaging Mri ◽  
Tomographic Angiography

Introduction: Chordomas are rare low-grade malignant lesions that are mostly seen in the spine. They constitute about 1% of intracranial tumors and 3-4% of all primary bone tumors. The principal spinal location is usually the sacrococcygeal and infrequently the sphenooccipital and cervical areas. Case Presentation: We present a 74-year-old man with a huge sacrococcygeal mass extending to both buttocks. Computerized tomography (CT-scan) and magnetic resonance imaging (MRI) as well as computerized tomographic angiography (CTA) evaluations were suggestive to chordoma. Immunohistochemical analysis confirmed the diagnosis after the patient was successfully operated on. All aggravating symptoms resolved after the operation. Conclusion: The management of giant sacrococcygeal chordomas can be very challenging but with all-inclusive treatment, complete cure is achievable although recurrence can occur. In our case, surgery alone was curative. Preoperative CTA aided us in achieving total tumor resection.

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 New Insights about the Wnt/β-Catenin Signaling Pathway in Primary Bone Tumors and Their Microenvironment: A Promising Target to Develop Therapeutic Strategies?

2019 ◽  
Vol 20 (15) ◽  
pp. 3751 ◽  
Author(s):  
Danieau ◽  
Morice ◽  
Rédini ◽  
Verrecchia ◽  
Royer
Keyword(s):  
Signaling Pathway ◽  
Ewing Sarcoma ◽  
Bone Tumors ◽  
Tumor Resection ◽  
Therapeutic Strategies ◽  
Bone Homeostasis ◽  
Current Standard ◽  
Primary Bone Tumors ◽  
Promising Target ◽  
Primary Bone

Osteosarcoma and Ewing sarcoma are the most common malignant primary bone tumors mainly occurring in children, adolescents and young adults. Current standard therapy includes multidrug chemotherapy and/or radiation specifically for Ewing sarcoma, associated with tumor resection. However, patient survival has not evolved for the past decade and remains closely related to the response of tumor cells to chemotherapy, reaching around 75% at 5 years for patients with localized forms of osteosarcoma or Ewing sarcoma but less than 30% in metastatic diseases and patients resistant to initial chemotherapy. Despite Ewing sarcoma being characterized by specific EWSR1-ETS gene fusions resulting in oncogenic transcription factors, currently, no targeted therapy could be implemented. It seems even more difficult to develop a targeted therapeutic strategy in osteosarcoma which is characterized by high complexity and heterogeneity in genomic alterations. Nevertheless, the common point between these different bone tumors is their ability to deregulate bone homeostasis and remodeling and divert them to their benefit. Therefore, targeting different actors of the bone tumor microenvironment has been hypothesized to develop new therapeutic strategies. In this context, it is well known that the Wnt/β-catenin signaling pathway plays a key role in cancer development, including osteosarcoma and Ewing sarcoma as well as in bone remodeling. Moreover, recent studies highlight the implication of the Wnt/β-catenin pathway in angiogenesis and immuno-surveillance, two key mechanisms involved in metastatic dissemination. This review focuses on the role played by this signaling pathway in the development of primary bone tumors and the modulation of their specific microenvironment.

scholarly journals Why Rotationplasty? A Qualitative Study of Decision-Making by Families of Patients With Primary Bone Sarcoma

2022 ◽  
Vol 9 ◽  
pp. 237437352110698
Author(s):  
Chung M Chan ◽  
Adam D. Lindsay ◽  
Andre R V Spiguel ◽  
C. Parker Gibbs ◽  
Mark T Scarborough
Keyword(s):  
Decision Making ◽  
Tumor Resection ◽  
Bone Sarcoma ◽  
Surgical Reconstruction ◽  
Decision Making Process ◽  
Structured Interviews ◽  
Primary Bone Tumors ◽  
Primary Bone Sarcoma ◽  
Primary Bone ◽  
Established Technique

Rotationplasty is an established technique that is indicated as part of the surgical reconstruction for certain patients with primary bone tumors around the knee who undergo tumor resection. There is considerable variation in the application of rotationplasty by surgeons as well as acceptance of the procedure by patients who may be candidates for this procedure. We qualitatively studied the decision-making process of families of patients who had undergone rotationplasty by interviewing 4 patients and their families using semi-structured interviews. Thematic analysis identified the following themes that were important in the decision-making process: (1) the desire for good information sources, (2) finding value in meeting with other patients who had been faced with a similar decision, (3) prioritizing function over cosmesis, (4) a desire to limit the need for revision surgeries, and (5) accepting that a return to normalcy is not an option with a surgery. Physicians and patients faced with a similar decision can benefit from a better understanding of the process, and by the normalization of anxieties and concerns that they may experience.

scholarly journals Computer Assisted Surgery and 3D Printing in Orthopaedic Oncology: A Lesson Learned by Cranio-Maxillo-Facial Surgery

2021 ◽  
Vol 11 (18) ◽  
pp. 8584
Author(s):  
Giuseppe Bianchi ◽  
Tommaso Frisoni ◽  
Benedetta Spazzoli ◽  
Alessandra Lucchese ◽  
Davide Donati
Keyword(s):  
3D Printing ◽  
Pelvic Surgery ◽  
Patient Specific ◽  
Computer Assisted ◽  
Mechanical Complication ◽  
Orthopaedic Oncology ◽  
Custom Made ◽  
Patient Specific Instruments ◽  
Primary Bone ◽  
Custom Made Prostheses

Primary bone sarcomas are rare tumors and surgical resection in combination with chemo and radiation therapy is the mainstay of treatment. Some specific anatomical sites still represent a reconstructive challenge due to their complex three-dimensional anatomy. In recent years, patient specific instruments along with 3D printing technology has come to represent innovative techniques in orthopaedic oncology. We retrospectively reviewed 23 patients affected by primary bone sarcoma treated with patient-specific instruments and 3D printing custom made prostheses. At follow up after approximately two years, the infection rate was 26%, mechanical complication rate 13%, and local recurrence rate 13% (with a five-years implant survival rate of 74%). Based on our experience, patient-specific instruments and 3D custom-made prostheses represents a reliable and safe technique for improving the accuracy of resection of primary bone tumour, with a particular use in pelvic surgery ameliorating functional results.

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

1982 ◽  
Vol 21 (04) ◽  
pp. 136-139 ◽  
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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