最近経験した患し保存手術例の検討

Abstract

Three cases with bone soft tissue sarcoma, treated by limb-salvage operation are reported.Case 1: A thirty-five years old man had the recurrent mass at the left thigh, considered histologically as malignant fibrous histiocytoma and multiple metastatic pulmonary nodules when he was admitted. The local mass was evaluated as Stage III (extracompartmental lesion, high grade and pulmonary metastasis) by surgical grading system by Enneking (1981). After preoperative chemotherapy, marginal excision was performed. No local recurrence is observed one year and two months after surgery.Case 2: An eighteen years old boy had osteosarcoma of the left fibula. As the osteosarcoma was evaluated as Stage IIB (Extracompartmental lesion and high grade), wide local resection was performed after adjuvant chemotherapy consisting of vincristine and high dose methotrexate with citrovoruin factor rescue. He is the disease free survivor at one year after adjuvant chemotherapy.Case 3: A forty-seven years old woman had chondrosarcoma (grade 1 on Evans' classification) of the left femoral neck, diagnosed by aspiration biopsy. The chondrosarcoma was evaluated as Stage IA (intracompartmental lesion and low grade). The chondrosarcoma was removed by wide local resection and the bony defect was replaced by cermic femoral prosthesis. She can walk on one cratch at three months after surgery.