Internal Hemipelvectomy and Pelvic Reconstruction With Non-Vascularized Fibular Graft for Chondrosarcoma Ilium

Abstract

Chondrosarcoma is the third most common primary malignant bone tumor. The pelvis is the most common site with iliac bone being frequently involved. Hindquarter amputation was the standard treatment for pelvic osteosarcoma for years. Resection of tumors with wide margins gained popularity with advances in the medical field. The only resection without reconstruction of the pelvis has its own demerits which paved way for methods of reconstruction. One of these is pelvic reconstruction with non-vascularised fibular graft among many other methods, which is simple, cost-effective, and has a good functional outcome. Here, we are reporting a case of exophytic chondrosarcoma of intermediate grade in ilium in a 19-year-old male for whom internal hemipelvectomy (Enneking and Dunham type 1) and pelvic reconstruction with nonvascularised fibular graft was done with the excellent functional and radiological outcome, with a two-year follow-up.

Reconstruction of Type I-II Internal Hemipelvectomy in a Patient With Pelvic Myxoid Chondrosarcoma: A Case Report

“…Clinically, our patient presented dull and constant pain, as most patients with this diagnosis [2,3]. Radicular-type pain, sensory or motor disturbances, deep vein thrombosis (DVT), claudication, or changes in bowel function are suggestive of advanced disease due to the direct infiltration or extrinsic compression of the tumor [1].…”

“…Chemotherapy and radiotherapy do not have a role as effective adjuvants against chondroid tumors [ 2 , 3 , 5 ]. External hemipelvectomy (radical limb amputation) was the gold standard for many years due to the complex anatomy of the pelvis, the extent of many tumors at the moment of diagnosis, and the difficulty in reconstructing major bone defects [ 2 ].…”

“…Bone tumors of the pelvis represent 10%-15% of primary malignant bone tumors [ 1 ]. Chondrosarcoma is the third most common, after myeloma and osteosarcoma, accounting for one of five malignant bone tumors [ 2 ]. Chondrosarcoma is a tumor producing a non-osteoid cartilage matrix by neoplastic cells [ 3 ].…”

“…Chondrosarcoma is a tumor producing a non-osteoid cartilage matrix by neoplastic cells [ 3 ]. It usually affects adults between 40 and 70 years old, with the pelvis being the most frequent location, and is often present in men [ 1 , 2 , 4 ].…”

“…A systematic review analyzed the clinical outcomes of internal hemipelvectomy, comparing up to seven types of reconstruction techniques, with unique challenges and complications for each method [ 8 ]. Moreover, only case reports or case series are usually reported, due to the rarity of the disease [ 1 , 2 ].…”