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Osteosarkommanifestation bei chronischer Osteomyelitis

2 Fallberichte

Manifestation of osteosarcoma of chronic osteomyelitis

2 case reports

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Zusammenfassung

Wir berichten über die Therapie von 2 Patienten mit Osteosarkomen nach langjähriger Osteomyelits der unteren Extremität. Es erfolgte eine En-bloc-Resektion und Stabilisierung mittels Zementspacer. Nach Infektsanierung und Chemotherapie erfolgte im Intervall die definitive Versorgung mittels Umkippplastik des distalen Femurs sowie vaskularisierter lokaler Fibulatransposition und beidseitigem Gastrocnemiuslappentransfers im 1. Fall und Implantation eines Custom-made-Diaphysenersatzes im 2. Fall. Beide Patienten zeigten 1 Jahr postoperativ kein Tumorrezidiv und sind infektfrei.

Abstract

The treatment and outcome of two patients suffering from osteosarcoma of the lower extremity evolving many years after manifestation of chronic osteomyelitis are reported. After neoadjuvant polychemotherapy in one patient en bloc resection, interposition of a cement spacer and stabilization was performed in both cases. After eradication of infections final segmental reconstruction was accomplished by knee arthrodesis using rotation plasty of the split femoral condyle, free local fibula transposition and gastrocnemius muscle transfer. A custom-made diaphyseal replacement (3D-rapid prototyping titanium mesh) was used for defect reconstruction. After 1 year postoperative follow-up and restaging both patients showed no evidence of recurrent disease and had no local or systemic signs of infection.

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Literatur

  1. Fenoy AJ, Greenlee JD, Menezes AH (2006) Primary bone tumors of the spine in children. J Neurosurg 105:252–260

    PubMed  Google Scholar 

  2. Fechner RE, Mills SE (1993) Tumors of the bones and joints. In: Atlas of tumor pathology, 3rd series, fasc. 8. Armed Forces Institute of Pathology, Washington, DC

  3. Rowlands BC (1953) Carcinoma developing in chronic osteomyelitis. Br J Surg 41(165):106–107

    Article  PubMed  CAS  Google Scholar 

  4. McGrory JE, Pritchard DJ, Unni KK et al (1999) Malignant lesions arising in chronic osteomyelitis. Clin Orthop 362:181–189

    PubMed  Google Scholar 

  5. White C, Weidman FD (1927) Pseudo-epitheliomatous hyperplasia at the margins of cutaneous ulcers. J Am Med Assoc 88:1959–1963

    Article  Google Scholar 

  6. Benedict EB (1931) Carcinoma in osteomyelitis. Surg Gyn Obst 53:1–11

    Google Scholar 

  7. Henderson MS, Swart HA (1936) Chronic osteomyelitis associated with malignancy. J Bone Joint Surg 18:56–60

    Google Scholar 

  8. McAnally AK, Dockerty MB (1949) Carcinoma developing in chronic draining cutaneous sinuses and fistulas. Surg Gyn Obst 88:87–96

    PubMed  CAS  Google Scholar 

  9. Fitzgerald RH Jr, Brewer NS, Dahlin DC (1976) Squamous-cell carcinoma complicating chronic osteomyelitis. J Bone Joint Surg Am 58:1146–1148

    PubMed  Google Scholar 

  10. Akbarnia BA, Wirth CR, Colman N (1976) Fibrosarcoma arising from chronic osteomyelitis: case report and review of literature. J Bone Joint Surg Am 58:123–125

    PubMed  CAS  Google Scholar 

  11. Horvai A, Unni KK (2006) Premalignant conditions of bone. J Orthop Sci 11:412–423

    Article  PubMed  Google Scholar 

  12. Puri A, Parasnis AS, Udupa KV et al (2003) Fibroblastic osteosarcoma arising in chronic osteomyelitis. Clin Radiol 58:170–172

    Article  PubMed  CAS  Google Scholar 

  13. Sirikulchayanonta V, Sathaphatayavongs B, Dhaphasut N (1978) Parosteal osteogenetic sarcoma arising from a chronic draining sinus. J Med Assoc Thai 61:602–607

    PubMed  CAS  Google Scholar 

  14. Unni KK, Dahlin DC (1979) Premalignant tumors and conditions of bone. Am J Surg Pathol 3:47–60

    Article  PubMed  CAS  Google Scholar 

  15. Aberg M, Rydholm A, Holmberg J, Wieslander JB (1988) Reconstruction with a free vascularized fibular graft for malignant bone tumor. Acta Orthop Scand 59:430–437

    Article  PubMed  CAS  Google Scholar 

  16. Enneking WF, Eady JL, Burchardt H (1980) Autogenous cortical bone grafts in the reconstruction of segmental skeletal defects. J Bone Joint Surg Am 62:1039–1058

    PubMed  CAS  Google Scholar 

  17. Gebert C, Hardes J, Hoffmann C et al (2002) Chirurgische Therapieoptionen bei malignen Knochentumoren. Chirurg 73:1162–1169

    Article  PubMed  CAS  Google Scholar 

  18. Gosheger G, Winkelmann W (2000) Mutars – a modular tumor – and revision system. Experiences at the Münster Tumor Center. Othropade 29(1):554–555

    Google Scholar 

  19. Seybold U, Talati NJ, Kizilbash Q et al (2007) Hematogenous osteomyelitis mimicking osteosarcoma due to community associated methicillin-resistant staphylococcus aureus. Infection 35(3):190–193

    Article  PubMed  CAS  Google Scholar 

  20. Tow BPB, Tan MH (2005) Delayed diagnosis of Ewing’s sarcoma of the right humerus initially treated as chronic osteomyelitis: a case report. J Orthop Surg 13(1):88–92

    CAS  Google Scholar 

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Authors and Affiliations

  1. Centrum für Muskuloskelettale Chirurgie, Charité – Universitätsmedizin Berlin, Campus Virchow, Augustenburger Platz 1, 13353, Berlin, Deutschland

    C. Druschel, T. Pirvu, K.D. Schaser, P. Schwabe & I. Melcher

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  1. C. Druschel
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  2. T. Pirvu
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  3. K.D. Schaser
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  4. P. Schwabe
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  5. I. Melcher
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Correspondence to C. Druschel.

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Druschel, C., Pirvu, T., Schaser, K. et al. Osteosarkommanifestation bei chronischer Osteomyelitis. Unfallchirurg 116, 854–859 (2013). https://doi.org/10.1007/s00113-012-2315-8

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  • DOI: https://doi.org/10.1007/s00113-012-2315-8

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