Successful joint preservation of distal radius osteosarcoma by en bloc tumor excision and reconstruction using a tumor bearing frozen autograft: a case report

Abstract

BackgroundThe wrist joint is an extremely rare site for osteosarcoma. Joint structure preservation to maintain good limb function is well described in case of knee osteosarcoma, whereas it is not described in case of wrist joint osteosarcoma. In this report, we present the first case of joint preservation surgery to treat distal radius osteosarcoma using a tumor bearing autograft treated with liquid nitrogen.Case presentationA 46-year-old male presented with swelling and pain in the right wrist and was diagnosed with conventional osteosarcoma of the distal radius. The patient responded well to neoadjuvant chemotherapy and the tumor shrank remarkably. Wide tumor excision to preserve the radiocarpal joint and reconstruction with a tumor bearing frozen autograft were performed. Partial bone union was detected 3 months postoperatively and complete bone union was detected 9 months postoperatively. Following the surgery, there was immediate commencement of the range of motion (ROM) training in both the wrist and fingers. At the final postoperative follow-up of 41 months, the patient had normal ROM in the wrist, fingers, and forearms, with a score of 100% in the Musculoskeletal Tumor Society (MSTS) score and was disease free.ConclusionWe present the first case in which en bloc tumor excision with joint preservation of the wrist and reconstruction using a tumor bearing frozen autograft were performed. The surgery yielded excellent hand, wrist, and forearm function at the final follow-up.

Intercalary reconstruction with successful joint preservation by uncemented 3D‑printed endoprosthesis following tumor resection in distal radius: A case report

“…Resection with joint preservation can salvage the majority of wrist function but, as a challenging procedure, it can also lead to an ultra-critical sized bone defect which is technically demanding to reconstruct (5,6). Previous reports regarding wrist joint sparing surgery are rare (7,8). The present study reported a case of wrist preservation surgery using a 3D-printed custom-made porous endoprosthesis after en bloc resection of the EHE in the distal radius.…”

Unusual Location of Bone Tumor Easily Misdiagnosed: Distal Radius Osteosarcoma Treated as Osteomyelitis

“…With an incidence of 0.3-0.5 per 100,000, osteosarcoma is the most frequent non-hematopoietic primary malignant bone tumor [ 5 ]. According to studies, the distal radius is a common skeletal site for primary bone tumors, but not for osteosarcomas, as only 1% of osteosarcomas are found in the distal radius [ 6 , 7 ]. Uribe-Botero et al [ 8 ] investigated 243 cases with primary osteosarcoma of bone, and they found (49.8%) of tumors arising in the femur to be the first most frequent site, then tibia to be the second most common site, with 47 cases (19.3%), while only one case of distal radius osteosarcoma is recorded.…”

Liquid nitrogen for cryotherapy treatment for osteosarcoma of the middle femur: A case report

“…[4][5][6] While, in this case, the liquid ammonia freezing and inactivating was simple and accurate, which was considered to be a better way to treat tumor bone. 12 This study noted the following points in specific clinical work:…”