Early outcome of palliative limb salvage surgery in patient with right proximal humerus osteosarcoma Enneking III at Dr. Soetomo Academic General Hospital: A case report
Department of Orthopaedic and Traumatology, Faculty of Medicine, Universitas Airlangga/ Dr. Soetomo General Academic Hospital, Surabaya, Indonesia.
Case Study
World Journal of Advanced Research and Reviews, 2024, 21(03), 2498–2507
Publication history:
Received on 14 February 2024; revised on 25 March 2024; accepted on 27 March 2024
Abstract:
Introduction: Osteosarcoma is a type of bone cancer that commonly affects the long bones, including the proximal humerus. This case report aims to investigate the clinical outcomes of patients with osteosarcoma of the proximal humerus enneking III. Follow-up assessments were conducted to evaluate post-operative outcomes.
Case Presentation: This was a case report of a 33-year-old man who came to an outpatient clinic referred from another island with a chief complaint huge lump in his right shoulder 6 years ago. The patient got several examinations and was diagnosed with osteosarcoma of proximal humerus enneking III accompanied by lung metastases. From the Clinical Pathological Conference (CPC) patient decided to do neoadjuvant chemotherapy followed by restaging and amputation, but the patient refused amputation. Since it was found that the neurovasculature was not encased, limb salvage palliative surgery was performed, in the form of wide resection surgery, reconstruction with bone cement and spacers, and also shoulder reconstruction with prolene mesh, then followed by adjuvant chemotherapy. Follow-up 15 months post-op showed there were no recurrences, stable lung metastases, and improvement in complications, Musculoskeletal Tumor Society (MSTS) score 26 out of 30 and Disabilities of the Arm, Shoulder and Hand (DASH) scores 37.9 out of 100.
Conclusion: In this case, the decision to undergo palliative limb salvage surgery is not an ordinary decision. Even though the outcome is not good, the patient is satisfied with the results, and with routine physiotherapy, we can assess the improvement and progressivity of the results of the operation.
Keywords:
Osteosarcoma; Humerus; Enneking III; Limb salvage palliative surgery; DASH; MSTS
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