A novel treatment strategy for high grade chondrosarcoma patients utilizing a biological allograft and a native femoral head: a report and review of literature.

 

Algimantas Jonas Puteris1,  Prof. Šarūnas Tarasevičius2, Dr. Mindaugas Stravinskas3

1Faculty of Medicine, Lithuanian University of Health Sciences, Kaunas Lithuania

2Department of Orthopedics and Traumatology, Faculty of Medicine, Lithuanian University of Health Sciences, Kaunas, Lithuania

3Department of Orthopedics and Traumatology, Faculty of Medicine, Lithuanian University of Health Sciences, Kaunas, Lithuania

 

ABSTRACT

Backround and Aim: Chondrosarcomas are amongst the most common malignancies affecting the musculoskeletal system. Despite the fact that overall incidence of these tumours is relative rare, approximately 3 new cases are diagnosed each year per 100,000 inhabitants with a higher tendency to affect people above the age of 50 (1). In more advanced disease, adequate surgical resection margins are difficult to achieve especially when sites such as the pelvic compartment are affected. Surgical approaches tend to be limited to amputation of wide en-block resections with endoprosthesis of the femur leading to significant morbidity in patients. Our aim was to present a possible treatment alternative for future treatment alternatives in patients diagnosed with high grade pelvic chondrosarcomas using a biological allograft from a cadaveric donor which matches the patient’s native femoral head.

Materials and methods: We present a case of a 63-year-old woman complaining of pain in her leg which has been affecting her for over a year.  Using a biological allograft from a cadaveric donor and the patient’s native femoral head a wide en-bloc excision was performed to treat her central chondrosarcoma.

Results: The patient was successfully treated using a biological allograft while maintaining her native femoral head. Unforseen aseptic necrosis developed two years following the procedure and was treated using a metal endoprosthesis. MSTS functional scoring remained unchanged following both procedures.

Conclusion: Wide en-bloc excisions during the oncological treatment of pelvic chondrosarcomas using biological allografts and native femoral heads may be used without impairing care or functional outcome in the future.

Key Words: Pelvic chondrosarcoma, biological allograft, native femoral head.