Abstract
The case of a patient with a second recurrence of a chondrosarcoma of the pelvis and pubic symphysis is presented, in order to show the difficulties of the surgical treatment and the long course of the tumor.A 56-year-old woman having already been operated upon twice within two decades, presented with a large, mass of the pubic symphysis, extending into the left proximal thigh.Preoperative imaging revealed a large tumor occupying the pubic symphysis and the pubic bones up to the ischial tuberosities, extending into the soft tissues of the inner surface of the left thigh and displacing the urinary bladder, the urethra and the vagina.Intraoperatively, a radical excision of the tumor was performed, including removal of the osseous substrate of the anterior pelvis. The anterior abdominal wall was supported with a special synthetic mesh secured on the osseous stumps in order to prevent visceral herniation. Histological examination showed grade I to II chondrosarcoma, while the patient’s postoperative course was uncomplicated.At the latest follow-up two years postoperatively, the patient is pain-free and ambulatory with no signs of tumor recurrence, genitourinary complications or visceral herniation.
Highlights
Chondrosarcoma is the third most common primary bone malignancy after myeloma and osteosarcoma, accounting for approximately 20% of bone sarcomas and mainly affecting the middle-aged population
The case of a patient with a second recurrence of a chondrosarcoma of the pelvis and pubic symphysis is presented, in order to show the difficulties of the surgical treatment and the long course of the tumor
Since radiotherapy and chemotherapy have proved ineffective in the treatment of chondrosarcomas, wide surgical excision remains the treatment of choice [1,5]
Summary
Chondrosarcoma is the third most common primary bone malignancy after myeloma and osteosarcoma, accounting for approximately 20% of bone sarcomas and mainly affecting the middle-aged population. It comprises a heterogeneous group of neoplasms that are characterized by cartilage matrix production from the tumor cells [1,2,3]. We hereby present a case of a twice recurrent pelvic chondrosarcoma occupying the pubic symphysis that was treated by wide marginal excision and abdominal wall reconstruction with the use of a special synthetic mesh in order to prevent a postoperative visceral herniation. The patient was symptom-free and satisfied with the results of her treatment
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