Abstract
Management of metastatic bone disease is still evolving and is dependent upon many factors including the primary tumour type, expected life expectancy, site and size of lesion, character of the lesion, lytic or blastic, and the number of lesions. Active orthopaedic surgical intervention is usually required at the time of pathological fracture either impending or actual. Management options are either in situ fixation or replacement/arthroplasty. The role of post-operative radiotherapy is still not clearly defined and its biological effect on healing of pathological fracture is unclear. In this report, we describe a case of breast carcinoma with a large metastatic lytic lesion in the proximal femur, which was treated by in situ fixation followed by hormonal therapy and external beam radiotherapy. In the post-operative period, rapid and dramatic ossification and reformation of the proximal femur was observed.
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Quattrocchi CC, Piciucchi S, Sammarra M, Santini D, Vincenzi B, Tonini G, Grasso RF, Zobel BB (2007 Oct) Bone metastases in breast cancer: higher prevalence of osteosclerotic lesions. Radiol Med (Torino) 112(7):1049–1059
Mirels H (1989) Metastatic disease in long bones: a proposed scoring system for diagnosing impending pathologic fractures. Clin Orthop Relat Res (249):256–264
Kunec JR, Lewis RJ (1984) Closed intramedullary rodding of pathologic fractures with supplemental cement. Clin Orthop Relat Res 188:183–186
Pala E, Trovarelli G, Calabrò T, Angelini A, Abati CN, Ruggieri P (2015 Mar) Survival of modern knee tumor megaprostheses: failures, functional results, and a comparative statistical analysis. Clin Orthop Relat Res 473(3):891–899
Lutz S, Lo S, Howell D et al (2011) American College of Radiology ACR Appropriateness Criteria® NON-SPINE BONE METASTASES expert panel on radiation oncology–bone metastases. J Palliat Med
Bonarigo BC, Rubin P (1967 May) Nonunion of pathologic fracture after radiation therapy. Radiology 88(5):889–898
McBride WH, Withers HR (2004) Biological basis of radiation therapy. In: Perez CA, Brady LW, Halperin EC, Schmidt-Ullrich RK (eds) Principles and practice of radiation oncology, 4th edn. Lippincott Williams & Wilkins, Philadelphia, pp 96–136
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Kharbanda, Y., Singh, R., Mir, T. et al. Extensive Re-ossification and Reformation of the Proximal Femur After External Beam Radiotherapy in Metastatic Carcinoma Breast. Indian J Surg Oncol 9, 394–397 (2018). https://doi.org/10.1007/s13193-018-0739-5
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DOI: https://doi.org/10.1007/s13193-018-0739-5