Reconstruction using a frozen autograft for a skull and humeral lesion of synchronous multicentric osteosarcoma after undergoing successful neoadjuvant chemotherapy: a case report and review of the literature
Abstract Background Synchronous multicentric osteosarcoma (SMOS) is a rare disease characterized by simultaneous multicentricity of intraosseous osteosarcoma without visceral involvement. SMOS, including a skull lesion, which occurs relatively rarely, and reconstruction using a frozen autograft afte...
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| Format: | Article |
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BMC
2021-01-01
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| Series: | BMC Surgery |
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| Online Access: | https://doi.org/10.1186/s12893-020-01018-w |
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| author | Yoshihiro Araki Katsuhiro Hayashi Norio Yamamoto Akihiko Takeuchi Shinji Miwa Kentaro Igarashi Takashi Higuchi Kensaku Abe Yuta Taniguchi Hirotaka Yonezawa Sei Morinaga Yohei Asano Takayuki Nojima Hiroyuki Tsuchiya |
| author_facet | Yoshihiro Araki Katsuhiro Hayashi Norio Yamamoto Akihiko Takeuchi Shinji Miwa Kentaro Igarashi Takashi Higuchi Kensaku Abe Yuta Taniguchi Hirotaka Yonezawa Sei Morinaga Yohei Asano Takayuki Nojima Hiroyuki Tsuchiya |
| author_sort | Yoshihiro Araki |
| collection | DOAJ |
| description | Abstract Background Synchronous multicentric osteosarcoma (SMOS) is a rare disease characterized by simultaneous multicentricity of intraosseous osteosarcoma without visceral involvement. SMOS, including a skull lesion, which occurs relatively rarely, and reconstruction using a frozen autograft after the excision of a lesion of SMOS has been infrequently reported previously. Case presentation We report an 18-year-old girl with SMOS, with lesions located in the left distal femur, right proximal humerus, and left occipital bone. Her major complaint was pain and swelling around the left knee joint. Asymptomatic lesions of the humerus and skull bone were detected on a systemic bone scan. No visceral organ metastasis was observed. A biopsy of the distal femoral lesion revealed osteosarcoma. Based on the histological findings, multiple bone lesions, and absence of visceral lesion, the clinical diagnosis of SMOS was made. After five courses of neoadjuvant chemotherapy with a regimen of doxorubicin and cisplatin, reconstruction using a tumor prosthesis following wide excision of the left distal femur was performed, and total necrosis was histologically observed in the retracted specimen. Following three cycles of adjuvant chemotherapy, tumor excision and reconstruction with a frozen autograft treated with liquid nitrogen was conducted for both lesions of the humerus and skull, rather than tumor prosthesis or synthetics, in order to retain a normal shoulder function, and to obtain a good cosmetic and functional outcome after treatment of the skull lesion. Further adjuvant chemotherapy could not be administered after the completion of the surgical treatment for all lesions because the adverse events due to chemotherapy were observed. At over 5 years after the diagnosis, she remains clinically disease-free. Conclusions An early correct diagnosis, the proper management of chemotherapy, and surgical treatment for all lesions are essential for achieving a good clinical outcome, even in SMOS including a skull lesion. By performing reconstruction using a frozen autograft for a proximal humeral lesion and a skull lesion after confirming the good histological efficacy of neoadjuvant chemotherapy for the primary lesion, the excellent function of the shoulder joint and a good cosmetic outcome at the site of the skull lesion was acquired without complications or recurrence. |
| first_indexed | 2024-12-17T21:16:22Z |
| format | Article |
| id | doaj.art-8fa15d353dfc41d2bd81db3e7dd57aa0 |
| institution | Directory Open Access Journal |
| issn | 1471-2482 |
| language | English |
| last_indexed | 2024-12-17T21:16:22Z |
| publishDate | 2021-01-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Surgery |
| spelling | doaj.art-8fa15d353dfc41d2bd81db3e7dd57aa02022-12-21T21:32:20ZengBMCBMC Surgery1471-24822021-01-0121111110.1186/s12893-020-01018-wReconstruction using a frozen autograft for a skull and humeral lesion of synchronous multicentric osteosarcoma after undergoing successful neoadjuvant chemotherapy: a case report and review of the literatureYoshihiro Araki0Katsuhiro Hayashi1Norio Yamamoto2Akihiko Takeuchi3Shinji Miwa4Kentaro Igarashi5Takashi Higuchi6Kensaku Abe7Yuta Taniguchi8Hirotaka Yonezawa9Sei Morinaga10Yohei Asano11Takayuki Nojima12Hiroyuki Tsuchiya13Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kanazawa UniversityDepartment of Orthopaedic Surgery, Graduate School of Medical Sciences, Kanazawa UniversityDepartment of Orthopaedic Surgery, Graduate School of Medical Sciences, Kanazawa UniversityDepartment of Orthopaedic Surgery, Graduate School of Medical Sciences, Kanazawa UniversityDepartment of Orthopaedic Surgery, Graduate School of Medical Sciences, Kanazawa UniversityDepartment of Orthopaedic Surgery, Graduate School of Medical Sciences, Kanazawa UniversityDepartment of Orthopaedic Surgery, Graduate School of Medical Sciences, Kanazawa UniversityDepartment of Orthopaedic Surgery, Graduate School of Medical Sciences, Kanazawa UniversityDepartment of Orthopaedic Surgery, Graduate School of Medical Sciences, Kanazawa UniversityDepartment of Orthopaedic Surgery, Graduate School of Medical Sciences, Kanazawa UniversityDepartment of Orthopaedic Surgery, Graduate School of Medical Sciences, Kanazawa UniversityDepartment of Orthopaedic Surgery, Graduate School of Medical Sciences, Kanazawa UniversityDepartment of Orthopaedic Surgery, Graduate School of Medical Sciences, Kanazawa UniversityDepartment of Orthopaedic Surgery, Graduate School of Medical Sciences, Kanazawa UniversityAbstract Background Synchronous multicentric osteosarcoma (SMOS) is a rare disease characterized by simultaneous multicentricity of intraosseous osteosarcoma without visceral involvement. SMOS, including a skull lesion, which occurs relatively rarely, and reconstruction using a frozen autograft after the excision of a lesion of SMOS has been infrequently reported previously. Case presentation We report an 18-year-old girl with SMOS, with lesions located in the left distal femur, right proximal humerus, and left occipital bone. Her major complaint was pain and swelling around the left knee joint. Asymptomatic lesions of the humerus and skull bone were detected on a systemic bone scan. No visceral organ metastasis was observed. A biopsy of the distal femoral lesion revealed osteosarcoma. Based on the histological findings, multiple bone lesions, and absence of visceral lesion, the clinical diagnosis of SMOS was made. After five courses of neoadjuvant chemotherapy with a regimen of doxorubicin and cisplatin, reconstruction using a tumor prosthesis following wide excision of the left distal femur was performed, and total necrosis was histologically observed in the retracted specimen. Following three cycles of adjuvant chemotherapy, tumor excision and reconstruction with a frozen autograft treated with liquid nitrogen was conducted for both lesions of the humerus and skull, rather than tumor prosthesis or synthetics, in order to retain a normal shoulder function, and to obtain a good cosmetic and functional outcome after treatment of the skull lesion. Further adjuvant chemotherapy could not be administered after the completion of the surgical treatment for all lesions because the adverse events due to chemotherapy were observed. At over 5 years after the diagnosis, she remains clinically disease-free. Conclusions An early correct diagnosis, the proper management of chemotherapy, and surgical treatment for all lesions are essential for achieving a good clinical outcome, even in SMOS including a skull lesion. By performing reconstruction using a frozen autograft for a proximal humeral lesion and a skull lesion after confirming the good histological efficacy of neoadjuvant chemotherapy for the primary lesion, the excellent function of the shoulder joint and a good cosmetic outcome at the site of the skull lesion was acquired without complications or recurrence.https://doi.org/10.1186/s12893-020-01018-wSynchronous multicentric osteosarcomaSkull lesionBone scanChemotherapyTotal necrosisFrozen autograft |
| spellingShingle | Yoshihiro Araki Katsuhiro Hayashi Norio Yamamoto Akihiko Takeuchi Shinji Miwa Kentaro Igarashi Takashi Higuchi Kensaku Abe Yuta Taniguchi Hirotaka Yonezawa Sei Morinaga Yohei Asano Takayuki Nojima Hiroyuki Tsuchiya Reconstruction using a frozen autograft for a skull and humeral lesion of synchronous multicentric osteosarcoma after undergoing successful neoadjuvant chemotherapy: a case report and review of the literature BMC Surgery Synchronous multicentric osteosarcoma Skull lesion Bone scan Chemotherapy Total necrosis Frozen autograft |
| title | Reconstruction using a frozen autograft for a skull and humeral lesion of synchronous multicentric osteosarcoma after undergoing successful neoadjuvant chemotherapy: a case report and review of the literature |
| title_full | Reconstruction using a frozen autograft for a skull and humeral lesion of synchronous multicentric osteosarcoma after undergoing successful neoadjuvant chemotherapy: a case report and review of the literature |
| title_fullStr | Reconstruction using a frozen autograft for a skull and humeral lesion of synchronous multicentric osteosarcoma after undergoing successful neoadjuvant chemotherapy: a case report and review of the literature |
| title_full_unstemmed | Reconstruction using a frozen autograft for a skull and humeral lesion of synchronous multicentric osteosarcoma after undergoing successful neoadjuvant chemotherapy: a case report and review of the literature |
| title_short | Reconstruction using a frozen autograft for a skull and humeral lesion of synchronous multicentric osteosarcoma after undergoing successful neoadjuvant chemotherapy: a case report and review of the literature |
| title_sort | reconstruction using a frozen autograft for a skull and humeral lesion of synchronous multicentric osteosarcoma after undergoing successful neoadjuvant chemotherapy a case report and review of the literature |
| topic | Synchronous multicentric osteosarcoma Skull lesion Bone scan Chemotherapy Total necrosis Frozen autograft |
| url | https://doi.org/10.1186/s12893-020-01018-w |
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