骨盤骨腫ようの治療上の問題点

Abstract

There are many problems to be resolved in the treatment of pelvic bone tumors, induding a high recurrence rate, postoperative infection, difficulty of reconstruction and postoperative functional disability.We experienced 10 cases of primary malignant pelvic bone tumors, (five cases of sacral chordomas, two chondrosarcomas, one osteosarcoma, one Ewing's sarcoma and one PNET). Sacral amputations were performed in all five cases of chordomas, and two cases recurred. The case with an osteosarcoma of the iliac bone was treated by wide resection and pre-and postoperative chemotherapy, and at the latest follow-up has no evidence of the disease. Two cases of chondrosarcomas were treated by intralesional resection, one of which recurred with the patient subsequently dying. The cases of Ewing's sarcoma and PNET were treated conservatively by chemotherapy and radiotherapy, with one still alive and healthy.Severe postoperative complications were noted among eight operative cases. Local recurrence is one of the major problems. As the surgical stumps of the two recurrent chordomas were both negative histopathologically, skip lesions may exist. Deep infection is another major complication. Three cases were infected with or without skin necrosis after surgery. Surgery was needed to treat the infection in two cases.