Ewings sarcoma of patella: A rare entity treated with a novel technique of extensor mechanism reconstruction using tendoachilles auto graft

Abstract

We report a case of Ewings sarcoma (ES) involving the patella in a young female. ES of patella is a rare entity. The patient was presented with anterior knee pain and swelling arising from the patella. She was treated with neoadjuvant chemotherapy followed by wide excision of the patella and reconstruction of the extensor mechanism using split tendoachilles auto graft. The patella is an uncommon site for primary or metastatic tumors of the bone. ES, though rare, should be included in the differential diagnosis of swellings arising from the patella. Auto graft from the tendoachilles is a good alternative for reconstructing the extensor mechanism of the knee. Core tip: We are presenting an article of Ewings sarcoma (ES) of the patella-a rare entity treated by a novel technique. The common reported tumors of the patella include chondroblastoma, giantcell tumor, osteosarcoma, metastasis, etc . We could not find any report on a single case of ES/PNET in the patella treated with patellectomy and extensor mechanism reconstruction using tendoachilles auto graft in the whole of English bio-medical literature. We present here a case of ES of the right patella in a 26 years old female. All reported extensor mechanism reconstructions after patellectomy were by tendoachilles allografts. We resorted to a novel technique of reconstruction of the extensor mechanism using tendoachilles auto graft.Valsalan RM, Zacharia B. Ewings sarcoma of patella: A rare entity treated with a novel technique of extensor mechanism reconstruction using tendoachilles auto graft. World J Orthop 2015; 6(9): 744-749 Available from:

Metastatic patellar bone tumor due to gastric cancer resembling a primary or secondary aneurysmal bone cyst: A case report

“…3 B-D). A tendon graft was not necessary as reported [ 17 , 19 ]. Furthermore, in our country, allograft is challenging [ 16 ].…”

“…Bone tumors are extremely rare, accounting for <1 % of all tumors, and most are benign or intermediate tumors such as chondroblastomas, osteoid osteomas, aneurysmal bone cysts, and giant cell tumors of the bone [ [1] , [2] , [3] ]. Malignant tumors such as osteosarcomas, chondrosarcomas, and Ewing's sarcomas have also been reported, but are extremely rare [ [17] , [18] , [19] ]. Metastatic bone tumors rarely occur.…”

Three-dimensional-printed custom-made patellar endoprosthesis for recurrent giant cell tumor of the patella: A case report and review of the literature

“…To date, total patellectomies have been reported in treating Campanacci grade III GCTB or malignant neoplasms arising from the patella[ 5 , 6 , 8 , 10 , 16 ]. To repair the consequent defect in the extensor mechanism, several reconstruction methods including end-to-end suture of the quadriceps tendon and patellar tendon[ 6 ], allografting[ 5 , 7 , 8 ], and autografting[ 10 , 11 ] have been proposed. Still, each of them has its demerits (Table 1 )[ 5 , 6 , 17 - 19 ].…”

Total patellectomy with extensor mechanism reconstruction following pathological fracture due to patellar Ewing’s sarcoma

“…Treatment regimen for resectable Ewing’s sarcoma involves neoadjuvant chemotherapy followed by a limb-salvage procedure and postoperative adjuvant chemotherapy 6. Valsalan and Zacharia7 well described this approach in their paper. However, they also described a novel technique whereby the extensor mechanism was reconstructed using a split tendo-Achilles autograft.…”