M. Augustus, Allan Ali, Allan Beharry, David Armorer, Derrick Lousaing
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The advances in orthopaedic surgical techniques and bioengineering of prosthesis have made this a viable option for these complex cases.Staging is performed using the Campanacci Radiographic Classification System and this is based on the radiological findings of the GCT. This staging system is used to guide the planning of the initial surgical management. Campanacci Stage III GCTs are aggressive lesions thus En bloc resection and reconstruction have been proposed as the choice of treatment. This is done with the goal of joint preservation as well as reducing the risk of recurrence. This case report highlights the challenges in the management of a Campanacci Grade III GCT of the distal femur. A mega prosthesis or endoprosthesis is a viable first-line treatment for oncological patients with significant bone and soft tissue loss. Oncological clearance was achieved then by the customized megaprosthesis was assembled and set in place. Procurement of this custom-made megaprosthesis during the COVID-19 pandemic was particularly challenging.","PeriodicalId":407871,"journal":{"name":"Indian Journal of Orthopaedics Surgery","volume":"85 22","pages":""},"PeriodicalIF":0.0000,"publicationDate":"2024-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Management of a Giant Cell tumors with megaprosthesis in a resource-limited setting\",\"authors\":\"M. Augustus, Allan Ali, Allan Beharry, David Armorer, Derrick Lousaing\",\"doi\":\"10.18231/j.ijos.2024.031\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"Giant Cell Tumors (GCTs) of bone are primary bone tumors that are benign. They are biologically aggressive and have metastatic potential after malignant transformation. There have been several cases of GCTs described in the medical literature. 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引用次数: 0
摘要
骨巨细胞瘤(GCT)是一种良性原发性骨肿瘤。它们具有生物侵袭性,恶变后有转移的可能。医学文献中已有多例关于巨细胞瘤的描述。如何治疗年轻人群中的并关节GCT是骨科肿瘤学面临的最大挑战之一。截肢曾是恶性骨肿瘤的标准治疗方法。骨科手术技术和生物工程的进步使保肢手术成为一种可行的治疗方案。保肢手术被认为是安全的,90% 的骨肿瘤病例都会接受保肢手术。骨科手术技术和假肢生物工程的进步使这种方法成为这些复杂病例的可行选择。分期采用坎帕纳奇放射学分类系统(Campanacci Radiographic Classification System),该系统基于 GCT 的放射学检查结果。该分期系统用于指导初期手术治疗计划。坎帕纳奇 III 期 GCT 属于侵袭性病变,因此建议选择整体切除和重建作为治疗方法。这样做的目的是保留关节并降低复发风险。本病例报告强调了治疗股骨远端 Campanacci III 级 GCT 所面临的挑战。对于骨和软组织损失严重的肿瘤患者来说,巨型假体或内假体是可行的一线治疗方法。在肿瘤清除后,再将定制的巨型假体组装到位。在 COVID-19 大流行期间,采购这种定制的巨型假体尤其具有挑战性。
Management of a Giant Cell tumors with megaprosthesis in a resource-limited setting
Giant Cell Tumors (GCTs) of bone are primary bone tumors that are benign. They are biologically aggressive and have metastatic potential after malignant transformation. There have been several cases of GCTs described in the medical literature. The management of juxta-articular GCTs in the young population is one of the greatest challenges in orthopaedic oncology. Amputations were once the standard treatment for malignant bone tumours. Advances in orthopaedic surgical techniques and bioengineering have made limb-sparing surgery a viable treatment option. Limb- salvage surgery is considered safe and is routinely undertaken for 90% of cases of bone tumors. The advances in orthopaedic surgical techniques and bioengineering of prosthesis have made this a viable option for these complex cases.Staging is performed using the Campanacci Radiographic Classification System and this is based on the radiological findings of the GCT. This staging system is used to guide the planning of the initial surgical management. Campanacci Stage III GCTs are aggressive lesions thus En bloc resection and reconstruction have been proposed as the choice of treatment. This is done with the goal of joint preservation as well as reducing the risk of recurrence. This case report highlights the challenges in the management of a Campanacci Grade III GCT of the distal femur. A mega prosthesis or endoprosthesis is a viable first-line treatment for oncological patients with significant bone and soft tissue loss. Oncological clearance was achieved then by the customized megaprosthesis was assembled and set in place. Procurement of this custom-made megaprosthesis during the COVID-19 pandemic was particularly challenging.