PDF(Pubmed)
Abstract：
BACKGROUND: Ewing\'s sarcoma is a primary bone tumor predominantly observed in children and adolescents, necessitating a multidisciplinary treatment approach. While localized cases have a 5-year survival rate of 60-70%, the prognosis is significantly worse in pelvic advanced cases with metastasis. Moreover, pelvic Ewing\'s sarcoma has the unique problem of leading to high rates of postoperative infection.
METHODS: We present the case of a Japanese 14-year-old boy with left iliac Ewing\'s sarcoma and multiple metastases. At the initial visit, imaging revealed a large tumor in the left iliac bone with extraosseous extension and metastasis to multiple sites. Neoadjuvant chemotherapy resulted in significant tumor reduction. Surgical resection was performed without pelvic ring reconstruction to enable early postoperative chemotherapy and minimize postoperative infection risk. Despite complete abductor muscle removal, the patient achieved a stable gait postoperatively by centering the load axis.
CONCLUSIONS: Our case highlights the successful management of a left iliac Ewing\'s sarcoma with multiple metastases, with a focus on functional preservation and infection risk reduction. Pelvic ring reconstruction was not performed to avoid postoperative complications, emphasizing the importance of early postoperative chemotherapy. The patient achieved a stable gait postoperatively, demonstrating the potential benefits of this approach in similar cases.
METHODS: We present the case of a Japanese 14-year-old boy with left iliac Ewing\'s sarcoma and multiple metastases. At the initial visit, imaging revealed a large tumor in the left iliac bone with extraosseous extension and metastasis to multiple sites. Neoadjuvant chemotherapy resulted in significant tumor reduction. Surgical resection was performed without pelvic ring reconstruction to enable early postoperative chemotherapy and minimize postoperative infection risk. Despite complete abductor muscle removal, the patient achieved a stable gait postoperatively by centering the load axis.
CONCLUSIONS: Our case highlights the successful management of a left iliac Ewing\'s sarcoma with multiple metastases, with a focus on functional preservation and infection risk reduction. Pelvic ring reconstruction was not performed to avoid postoperative complications, emphasizing the importance of early postoperative chemotherapy. The patient achieved a stable gait postoperatively, demonstrating the potential benefits of this approach in similar cases.
摘要：
背景：尤因肉瘤是主要在儿童和青少年中观察到的原发性骨肿瘤，需要多学科治疗方法。虽然局部病例的5年生存率为60-70%，盆腔晚期转移患者的预后明显较差。此外，骨盆尤因肉瘤具有导致术后感染率高的独特问题。
方法：我们介绍了一个日本14岁男孩，患有左髂尤因肉瘤和多发转移的病例。在初次访问时,影像学检查显示，左髂骨有一个大肿瘤，骨外延伸并转移到多个部位。新辅助化疗导致肿瘤显著减少。在不进行骨盆环重建的情况下进行了手术切除，以使术后早期化疗并最大程度地减少术后感染风险。尽管外展肌完全切除,患者通过使负载轴居中，实现了术后稳定的步态。
结论：我们的病例强调了左髂尤因肉瘤伴多发转移的成功治疗，专注于功能保存和降低感染风险。未进行骨盆环重建术以避免术后并发症,强调术后早期化疗的重要性。患者术后步态稳定，证明了这种方法在类似情况下的潜在好处。
方法：我们介绍了一个日本14岁男孩，患有左髂尤因肉瘤和多发转移的病例。在初次访问时,影像学检查显示，左髂骨有一个大肿瘤，骨外延伸并转移到多个部位。新辅助化疗导致肿瘤显著减少。在不进行骨盆环重建的情况下进行了手术切除，以使术后早期化疗并最大程度地减少术后感染风险。尽管外展肌完全切除,患者通过使负载轴居中，实现了术后稳定的步态。
结论：我们的病例强调了左髂尤因肉瘤伴多发转移的成功治疗，专注于功能保存和降低感染风险。未进行骨盆环重建术以避免术后并发症,强调术后早期化疗的重要性。患者术后步态稳定，证明了这种方法在类似情况下的潜在好处。
