Scapula Osteosarcoma
Journal Title: Biomedical Journal of Scientific & Technical Research (BJSTR) - Year 2017, Vol 1, Issue 3
Abstract
Although conventional osteosarcoma is one of the most common type of primary bone malignancy but fibroblastic subtype is rare enough to push us to report this case. We had experience with scapulectomy for conventional osteosarcoma with dominant fibroblastic component. The technique of surgery and safe margin in scapula were our debates.Osteosarcoma is the most common malignant bone tumor (if one excludes myeloma). Figure 1 show WHO classification of osteogenic tumors of bone (2013). Conventional probably is almost common type of osteosarcoma but about one percent of all conventional occur in flat bones and the number of fibroblastic presumably is rare, however, Frequency of fibroblastic subtype osteogenic sarcoma in 13 SEER registries between the years 1994 and 2008 was 111, and mean age in this series was 32 between 10 to 90 years old for this subtype [1]. Acceptable treatment for high grade conventional is wide resection after neoadjuvant chemotherapy and continue chemotherapy [1,2].Our Patient is a 34 years old young healthy man without any previous comorbidity, with history of couple of month progressing pain and bump on his scapula. After tumor work up including lab tests, Xray, CT scan, whole body bone scan, open biopsy was done in other center. Report of pathological paper was conventional osteosarcoma of scapula, then refer to us. Diagnose was not difficult because of characteristic of sarcoma. At the time of visit we faced with ill patient had severe pain, unable to sleep. We perform CTscan and MRI for lesion and chest, thorax surgeon and oncologist consulting (Figure 2). In Enneking system for staging benign and malignant musculoskeletal tumor that got high-grade with intra compartmental disease have no metastasis, means II-A. After patient and family negotiation we do neo adjuvant chemotherapy then after two month surgery was done intra articular total scapulectomy as Malawer et.al type 3 technique with elliptical oblique incision at lateral decobutos position as Duspital described (Figure 3). We followed patient for 18 months at time of this paper and any recurrence haven’t seen yet according to MRI (Figure 4).
Authors and Affiliations
Saberi Masoud, Mortazavi Nafiseh
Keywords
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- EP ID EP572816
- DOI 10.26717/BJSTR.2017.01.000291
- Views 142
- Downloads 0
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