En bloc resection followed by gluteal advancement flap for sacral Ewing's sarcoma: A novel technique.

IF 1.4 Q2 OTORHINOLARYNGOLOGY Journal of Craniovertebral Junction and Spine Pub Date : 2024-01-01 Epub Date: 2024-03-13 DOI:10.4103/jcvjs.jcvjs_162_23
Jeena Joseph, Krishna Prabhu, Edmond Jonathan, Mark Ranjan Jesudason, Ashish Kumar Gupta
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Abstract

Ewing's sarcoma is a rare and highly aggressive bone tumor primarily affecting children and adolescents. It commonly presents in the pelvic and axial skeleton, with sacral involvement posing unique challenges due to its intricate anatomical location. This report details the case of an 18-year-old male with sacral Ewing's sarcoma, emphasizing the diagnostic, surgical, and reconstructive aspects of management. The patient presented with lower back pain, lower limb weakness, and urinary incontinence, which prompted an extensive diagnostic evaluation. Magnetic resonance imaging and computed tomography scans revealed a large lytic mass extending from the S2 vertebra to the coccyx invading the presacral space. Biopsy confirmed the diagnosis of Ewing's sarcoma, characterized by the EWS-FLI1 type 1 translocation. A multidisciplinary team comprising neurosurgeons, colorectal surgeons, and plastic surgeons was formulated. En bloc resection of the tumor, lumbopelvic fixation, and soft-tissue reconstruction using bilateral gluteus maximus advancement flaps were successfully performed. The procedure aimed to address both the oncological and functional aspects of the patient's condition. Chemotherapy and radiotherapy were administered as adjuvant therapies. At 2-year follow-up, the patient was ambulating independently with no residual tumor on imaging. This case highlights the complex nature of sacral Ewing's sarcoma and underscores the importance of a multidisciplinary approach. The described surgical technique, including the innovative use of gluteus maximus advancement flaps for soft-tissue reconstruction, contributes to reducing wound complications and promoting successful patient outcomes. The presented approach serves as a valuable addition to the armamentarium of treatment options for this challenging malignancy.

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骶骨尤文氏肉瘤的整体切除术和臀部推进皮瓣术:一项新技术。
尤文氏肉瘤是一种罕见的高侵袭性骨肿瘤,主要影响儿童和青少年。它通常出现在骨盆和轴向骨骼中,骶骨受累因其复杂的解剖位置而带来独特的挑战。本报告详细介绍了一名患有骶骨尤文氏肉瘤的18岁男性患者的病例,强调了诊断、手术和重建方面的治疗。患者出现下背部疼痛、下肢无力和尿失禁,因此需要进行广泛的诊断评估。磁共振成像和计算机断层扫描显示,一个巨大的溶解性肿块从S2椎体延伸至尾骨,侵入骶前间隙。活检确诊为尤文氏肉瘤,其特征是 EWS-FLI1 1 型易位。一个由神经外科医生、结直肠外科医生和整形外科医生组成的多学科团队成立了。手术成功地进行了肿瘤的整体切除、腰椎固定以及使用双侧臀大肌推进瓣进行软组织重建。该手术旨在同时解决患者的肿瘤和功能问题。化疗和放疗是辅助治疗手段。随访两年时,患者已能独立行走,影像学检查无肿瘤残留。该病例凸显了骶骨尤文氏肉瘤的复杂性,强调了多学科治疗的重要性。所描述的手术技术,包括创新性地使用臀大肌前移瓣进行软组织重建,有助于减少伤口并发症,促进患者的康复。所介绍的方法为这种具有挑战性的恶性肿瘤的治疗方案提供了宝贵的补充。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
1.90
自引率
9.10%
发文量
57
审稿时长
12 weeks
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