Diagnosis and therapy of bone tumors in the area of the pelvis

Abstract

Classical signs of tumour development are seldom observed with pelvic tumours: swelling is recognized only late because of the deep, hidden localization; in addition many pelvic tumours belong to the cartilage-dependent group, which grow slowly, producing little if any pain. X-ray appearance is unusual because of the flat bones, which produce different tumour reaction and are oblique in space. All those factors render diagnosis of pelvic tumours difficult and often delayed. Not infrequently mistakes are seen with the performance of biopsy, if the surgeon is not aware of the needs of definitive therapy. Tumours proximal of the acetabulum are usually better contained, whereas those of the pubic and ischial bones quickly gain access to the areolar tissues around the throughways of arteries and nerves. A clear concept of the margin of resection will decide whether amputation or resection can be performed preserving a useful extremity. Secondary tumours and tumorlike lesions are the aim of intralesional curettage or resection using tumour prosthesis if necessary and possible. The reported experience has been gathered from the personal surgical performance for 80 tumours of the pelvic region.