International journal of surgery case reports · 2024
Grade III chondrosarcoma of the left iliopubic branch: A case report.
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Núñez-Rocha Ricardo E, Gómez-Carrillo Daniel, Estupiñan Laura Rincón, Medellín Anwar, Arbeláez Pablo, Herrera-Almario Gabriel E
Аннотация
INTRODUCTION AND IMPORTANCE: Chondrosarcomas are the third most frequent malignant bone tumors. With pelvic bones being their most common primary location, diagnosis and treatment of these tumors is especially challenging due to the diverse clinical manifestations and involvement of critical anatomic structures. We present the case of a grade III pelvic chondrosarcoma of the left iliopubic branch managed through a multidisciplinary approach.
CASE PRESENTATION: A 26-year-old male patient presented with a 1-year history of a mass in the left iliopubic branch. The imaging findings suggested chondrosarcoma and showed extrinsic compression of pelvic structures causing right hydronephrosis, marked elongation and tortuosity of the sigmoid colon, and anterior and superior displacement of the bladder. Following multidisciplinary meeting it was decided to perform a left hemicolectomy, colostomy, and internal hemipelvectomy in the 1-2-3 left zones, with resection of the intrapelvic and intra-abdominal tumor, and preservation of the left lower extremity. The patient presented two episodes of intestinal obstruction, which resolved with medical management. Was discharged without presenting further complications.
CLINICAL DISCUSSION: Chondrosarcomas management demands a methodical approach. Appropriate surgical strategy requires individualization according to the characteristics of the lesion and the degree of involvement of surrounding structures. Complete resection of the tumor and preservation of the lower extremity function are critical achievements.
CONCLUSION: This case underscores the effective management of a challenging tumor such as pelvic chondrosarcoma. The multidisciplinary approach and collaboration of several specialties was crucial to reach an appropriate surgical strategy.
CASE PRESENTATION: A 26-year-old male patient presented with a 1-year history of a mass in the left iliopubic branch. The imaging findings suggested chondrosarcoma and showed extrinsic compression of pelvic structures causing right hydronephrosis, marked elongation and tortuosity of the sigmoid colon, and anterior and superior displacement of the bladder. Following multidisciplinary meeting it was decided to perform a left hemicolectomy, colostomy, and internal hemipelvectomy in the 1-2-3 left zones, with resection of the intrapelvic and intra-abdominal tumor, and preservation of the left lower extremity. The patient presented two episodes of intestinal obstruction, which resolved with medical management. Was discharged without presenting further complications.
CLINICAL DISCUSSION: Chondrosarcomas management demands a methodical approach. Appropriate surgical strategy requires individualization according to the characteristics of the lesion and the degree of involvement of surrounding structures. Complete resection of the tumor and preservation of the lower extremity function are critical achievements.
CONCLUSION: This case underscores the effective management of a challenging tumor such as pelvic chondrosarcoma. The multidisciplinary approach and collaboration of several specialties was crucial to reach an appropriate surgical strategy.