Palliative embolization arteries or veins for a recurrent pelvic chondrosarcoma

Authors

  • Carlo Biz
  • Andrea Angelini
  • Alberto Crimі
  • Giulia Trovarelli
  • Vasilios Igoumenou
  • Andreas Mavrogenis
  • Pietro Ruggieri

DOI:

https://doi.org/10.15674/0030-59872019475-80

Keywords:

chondrosarcoma, pelvis, embolization, palliative, polyvinyl alcohol microparticles

Abstract

Chondrosarcoma is a malignant bone tumor characterized by the formation of cartilage structures of varying degrees of maturity. They account for approximately 20 % of malignant skeletal tumors. Chondrosarcoma most often affects the pelvis (iliac bone), the proximal femur and humerus, ribs. The chondrosarcoma of the pelvis has a low response to chemo-and radiation therapy, so they are usually resected by standard hemipelvectomy. New surgical reconstructive techniques allow surgeons to perform major reconstructions, thereby improving patients' quality of life. Clinical case: male, 64 years old, with complains of the left thigh pain for 6 months. The patient was made a comprehensive examination — standard X-rays, MRI and CT scan of the pelvis, biopsy of the pathological formation. Diagnosis: chondrosarcoma II clinical group, stage IIB. Primary surgery — wide-field excision and reconstruction with a massive bone allograft was performed and bipolar hip replacement. Two major local recurrences were detected in 3 years. Due to inefficiency of chemo-and radiation therapy, refusal of the patient from amputation, high degree of tumor vascularization, arterial embolization was applied. A selective study of both the medial and lateral femoral arteries was performed using a uroangiographic contrast medium. The achievement of complete devascularization of the greatest lesion was confirmed angiographically. After 20 days due to partial revascularization, re-embolization of the lateral circular femoral artery was made. The final embolization of all arterial branches that fed the tumor was performed after 3 months with acrylic (n-butyl 2-cyanoacrylate) glue for larger-sized vessels and microparticles of polyvinyl alcohol (150–250 μm) for the smallest branches. Conclusion: embolization can be effectively used as a palliative treatment for highly vascularized pelvic chondrosarcoma.

Author Biographies

Carlo Biz

Department of Orthopaedics and Orthopaedic Oncology, University of Padova. Italy

Doctor of Orthopaedics and Traumatology

Andrea Angelini

Department of Orthopaedics and Orthopaedic Oncology, University of Padova. Italy

Doctor of Orthopaedics and Traumatology

Alberto Crimі

Department of Orthopaedics and Orthopaedic Oncology, University of Padova. Italy

Doctor of Orthopaedics and Traumatology

Giulia Trovarelli

Department of Orthopaedics and Orthopaedic Oncology, University of Padova. Italy

Doctor of Orthopaedics and Traumatology

Vasilios Igoumenou

First Department of Orthopaedics, National and Kapodistrian University of Athens. Greece

Doctor of Orthopaedics and Traumatology

Andreas Mavrogenis

First Department of Orthopaedics, National and Kapodistrian University of Athens. Greece

Doctor of Orthopaedics and Traumatolog

Pietro Ruggieri

Department of Orthopaedics and Orthopaedic Oncology, University of Padova. Italy

Doctor of Orthopaedics and Traumatology

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How to Cite

Biz, C., Angelini, A., Crimі A., Trovarelli, G., Igoumenou, V., Mavrogenis, A., & Ruggieri, P. (2020). Palliative embolization arteries or veins for a recurrent pelvic chondrosarcoma. ORTHOPAEDICS TRAUMATOLOGY and PROSTHETICS, (4), 75–80. https://doi.org/10.15674/0030-59872019475-80

Issue

No. 4 (2019)

Section

SHORT REPORTS AND NEWS FROM PRACTICE

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Copyright (c) 2020 Carlo Biz, Andrea Angelini, Alberto Crimі, Giulia Trovarelli, Vasilios Igoumenou, Andreas Mavrogenis, Pietro Ruggieri

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