Large chondrosarcoma treated successfully with new surgical technique and bone grafts in a 9-year-old girl: Case report

一例9岁女孩巨大软骨肉瘤采用新型手术技术和骨移植成功治疗的病例报告

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Abstract

INTRODUCTION: Chondrosarcoma is the second most common after osteosarcoma. It mostly effects adults and elderly individuals, primarily seen in the pelvic and proximal femoral bone. Pain and pathological fractures are common symptoms. The tumor is resistant to radiotherapy and chemotherapy, so surgical excision is the most effective treatment. CASE PRESENTATION: A 9-year-old girl presented with vague pain in her left thigh. Physical examination and imaging revealed multiple osteolytic lesions in the thigh, and a biopsy confirmed classical chondrosarcoma. The patient underwent surgery, which involved excision of the tumor with a safety margin and the use of a Z-plasty technique. Synthetic graft granules were used to fill the excision area. The patient was followed-up over 8 years without complications and recurrence. DISCUSSION: Chondrosarcoma is classified based on histological characteristics and clinical behavior. Chondrosarcoma is resistant to chemotherapy and radiation. Treatment options depend on tumor characteristics, and reconstruction may be necessary. For low-grade chondrosarcomas in long bones, intralesional excision and curettage are commonly used, but wide excision may be necessary to minimize recurrence. Vascularized fibular autografts have the potential for weight-bearing, but complications such as fractures and donor site morbidity can occur. Allograft reconstruction may be associated with infection, fracture, delayed or nonunion. CONCLUSIONS: Treatment approaches vary based on factors such as tumor stage, grade, and location. Each option carries its own risks and complications, including infection, fracture, and delayed healing. This study suggests a new surgical technique using bone grafts.

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