BACKGROUNDEwing’s sarcoma is a highly malignant primary bone tumor that commonly affectschildren. For young patients, multidisciplinary treatment and limb salvage arerecommended, and surgical plans considering the gr...BACKGROUNDEwing’s sarcoma is a highly malignant primary bone tumor that commonly affectschildren. For young patients, multidisciplinary treatment and limb salvage arerecommended, and surgical plans considering the growth potential and boneactivity after tumor resection are essential.CASE SUMMARYAn 11-year-old Asian boy had a 1-mo history of a right-sided limping gait.Imaging revealed a proximal tumor with bone destruction and physealinvolvement over the right femoral neck. He was diagnosed with stage IV(T1N0M1aG3) Ewing’s sarcoma with bilateral lung metastases. Neoadjuvantchemotherapy decreased the tumor size and confined it to the metaphysealregion. The patient underwent four stages of surgery: wide tumor excision plusreconstruction with vascular fibular bone graft plus internal fixation;repeat openreduction and internal fixation;femoral lengthening with orthosis after physealmaturity;and orthosis removal and bone elongation (approximately 6 cm).Following surgery, he could walk without discomfort and had almost equal-sizedbilateral femoral heads, indicating physis preservation. The surgery wassuccessful, and normal femoral head growth was achieved after completeremission. The patient was able to resume normal activities with equal length ofthe bilateral lower limbs.CONCLUSIONTumor treatment and reconstruction following resection are important in skeletally immature patients with Ewing’s sarcoma to improve quality of life.展开更多
文摘BACKGROUNDEwing’s sarcoma is a highly malignant primary bone tumor that commonly affectschildren. For young patients, multidisciplinary treatment and limb salvage arerecommended, and surgical plans considering the growth potential and boneactivity after tumor resection are essential.CASE SUMMARYAn 11-year-old Asian boy had a 1-mo history of a right-sided limping gait.Imaging revealed a proximal tumor with bone destruction and physealinvolvement over the right femoral neck. He was diagnosed with stage IV(T1N0M1aG3) Ewing’s sarcoma with bilateral lung metastases. Neoadjuvantchemotherapy decreased the tumor size and confined it to the metaphysealregion. The patient underwent four stages of surgery: wide tumor excision plusreconstruction with vascular fibular bone graft plus internal fixation;repeat openreduction and internal fixation;femoral lengthening with orthosis after physealmaturity;and orthosis removal and bone elongation (approximately 6 cm).Following surgery, he could walk without discomfort and had almost equal-sizedbilateral femoral heads, indicating physis preservation. The surgery wassuccessful, and normal femoral head growth was achieved after completeremission. The patient was able to resume normal activities with equal length ofthe bilateral lower limbs.CONCLUSIONTumor treatment and reconstruction following resection are important in skeletally immature patients with Ewing’s sarcoma to improve quality of life.
