Pelvic sacral and hemi lumbar spine resection of low grade pelvic chondrosarcoma: a multistage procedure involving vascular bypass, spine fixation and vascular exclusion.
Peripheral chondrosarcoma is a rare tumor particularly insidious when arising from the pelvis, becoming symptomatic later in time when surgery may be too difficult and dangerous due to this complex area. In the present case, the tumor arose from an exostosis located on the medial surface of the left iliac wing. Its diameter was 25 cm × 20 cm × 15 cm, adhering to the last three vertebrae, involving the left iliac vein and artery, displacing the left ureter. In a similar case, a hindquarter amputation is indicated but, if the patient refuses, a resection remains possible. In this paper, we describe a multistage technique consisting of an extra-anatomic vascular bypass, a lumbar stabilization, a neurovascular bundles anterior isolation and a postero-lateral resection of this mass. After a five-year follow-up, the patient is alive and able to stand and walk with support, after undergoing twice lung metastasis removal.
Oncological Orthopaedics Department, Muscular-skeletal Tissue Bank, IFO-Regina Elena National Cancer Institute, Via Elio Chianesi 53, 00144 Rome, Italy; Department of Surgical Science, University of L'Aquila, L'Aquila, Italy. Electronic address: carminezoccali@libero.it.
C
C
Zoccali
G
G
Marolda
A
A
Di Francesco
L
L
Favale
N
N
Salducca
R
R
Biagini
D000792:Angiography; D001707:Biopsy, Needle; D001859:Bone Neoplasms / Q000098:blood supply / Q000175:diagnosis / Q000601:surgery*; D001863:Bone Screws; D002813:Chondrosarcoma / Q000098:blood supply / Q000175:diagnosis / Q000601:surgery*; D005263:Femoral Artery / Q000000981:diagnostic imaging; D005500:Follow-Up Studies; D006801:Humans; D007083:Iliac Artery / Q000000981:diagnostic imaging; D008159:Lumbar Vertebrae / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D010384:Pelvic Bones; D012447:Sacrum / Q000601:surgery*; D013123:Spinal Fusion / Q000379:methods*; D014057:Tomography, X-Ray Computed
Extra-anatomical vascular bypass; Lumbar resection; Pelvic chondrosarcoma; Pelvic resection; Pelvic tumor