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Total Sacrectomy for the Treatment of Advanced Pelvic Chondrosarcoma

  • Alvaro Gregorio MoralesEmail author
  • Jose Luis Garcia Sabrido
  • Jose Antonio Calvo
  • Ruben Perez Mañares
  • Maria Fernandez
  • Jose Manuel Asencio Pacual
Case Report
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Abstract

Primary tumors of sacrum are rare. The most common malignant tumors are metastasis, and only 6% of all malignant tumors arise from the sacrum. Chondrosarcoma is the third most common primary bone malignancy following myeloma and osteosarcoma. Surgery is usually the most important therapeutic modality; the wide en bloc excision remains the treatment of choice. These technically demanding procedures require a multidisciplinary expert team (neurosurgery, surgical and orthopedic oncology, colorectal surgery, and plastic surgery) involvement. We present in this article a case of a 52-year-old man who presented less infrequent symptoms, and the diagnosis was made in a very advanced stage. The wide surgical excision of the mass was performed by two different anterior and posterior approaches in one stage. The free surgical margins were difficult to achieve because it presented a voluminous tumor with invasion of the rectum, bone, and sacral plexus, but the age, low histological grade, and extensive experience in extreme pelvic surgery of our multidisciplinary team allowed approaching the patient with debulking surgery en bloc, successfully. Total hospital stay was 20 days. The patient was discharged without any complications. At the 6-months’ follow-up, the patient showed no local recurrence.

Keywords

Chondrosarcoma Sacrectomy Multidisciplinary 

Notes

References

  1. 1.
    Mavrogenis AF, Pavlos P, Georgia K, Papagelopoulos Panayiotis J (2009) Tumours of the sacrum. Orthop. 32:5–5Google Scholar
  2. 2.
    Hogendoorn PCW, Bovee JM, Nielsen GP (2013) Chondrosarcoma (grades I-III), including primary and secondary variants and periosteal chondrosarcoma. In: CDM F, Bridge JA, PCW H, Mertens F (eds) World Health Organization classification of tumours of soft tissue and bone, vol 5, 4th edn. IARC, Lyon, p 264Google Scholar
  3. 3.
    Gelderblom H, Hogendoorn PCW, Dijkstra SD et al (2008) The clinical approach towards chondrosarcoma. Oncologist 13(3):320–329CrossRefGoogle Scholar
  4. 4.
    Bjornsson J, McLeod RA, Unni KK, Ilstrup DM, Pritchard DJ (1998) Primary chondrosarcoma of long bones and limb girdles. Cancer. 83:2105–2119CrossRefGoogle Scholar
  5. 5.
    Angelini A, Guerra G, Mavrogenis AF et al (2012) Clinical outcome of central conventional chondrosarcoma. J Surg Oncol 106:929CrossRefGoogle Scholar
  6. 6.
    Wirbel RJ, Schulte M, Maier B, Koschnik M, Mutschler WE (2000) Chondrosarcoma of the pelvis: oncologic and functional outcome. Sarcoma 4(4):161–168CrossRefGoogle Scholar
  7. 7.
    Jullien-Petrelli AC, Asencio JM, Orue-Echebarria MI, Lozano P, Álvarez A, Serrano J, Calvo FM, Calvo-Haro JA, Lasso JM, García-Sabrido JL (2017 Sep 4) Role of intraoperative radiotherapy in the treatment of sacral chordoma. Spine J.Google Scholar
  8. 8.
    Sheth DS, Yasko AW, Johnson ME, Ayala AG, Murray JA, Romsdahl MM (1996) Chondrosarcoma of the pelvis. Prognostic factors for 67 patients treated with definitive surgery. Cancer 78:745–750CrossRefGoogle Scholar
  9. 9.
    Hsieh PC, Xu R, Sciubba DM, MJ MG, Nelson C, Witham TF, Wolinsky JP (2009) Long-term clinical outcomes following en bloc resections for sacral chordomas and chondrosarcomas. Spine. 34(20):2233–2239CrossRefGoogle Scholar
  10. 10.
    Fiorenza F, Abudu A, Grimer RJ et al (2002) Risk factors for survival and local control in chondrosarcoma of bone. J Bone Joint Surg Br 84:93CrossRefGoogle Scholar
  11. 11.
    Gillis CC, Street JT, Boyd MC, Fisher CG (Oct 2014) Pelvic reconstruction after subtotal sacrectomy for sacral chondrosarcoma using cadaveric and vascularized fibula autograft. J Neurosurg Spine 21(4):623–627CrossRefGoogle Scholar

Copyright information

© Indian Association of Surgical Oncology 2019

Authors and Affiliations

  • Alvaro Gregorio Morales
    • 1
    • 2
    Email author
  • Jose Luis Garcia Sabrido
    • 1
    • 2
  • Jose Antonio Calvo
    • 1
    • 2
  • Ruben Perez Mañares
    • 1
    • 2
  • Maria Fernandez
    • 1
    • 2
  • Jose Manuel Asencio Pacual
    • 1
    • 2
  1. 1.Universidad Complutense de MadridMadridSpain
  2. 2.Hospital General y Universitario Gregorio MarañonMadridSpain

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