Two cases of total bone endoprosthetic reconstructions as limb salvage following resection of rare malignancies of proximal femur and humerus

Abstract

The femur and humerus are the most common long bones affected by both primary and malignant tumors. The choice of limb salvage or amputation always remains a dilemma to achieve an optimum outcome. Two such patients of malignant tumors of the long bone, one in the proximal femur and the other at the humeral shaft, were managed at our center with limb salvage. The first patient is a 36-year-old male with a rare malignant nerve sheath tumor of proximal femur treated at a peripheral hospital with curettage and stabilization by an intramedullary nail for the lesion in the proximal femur, presuming it to be a benign lesion. He was subsequently managed by total femur resection followed by an endoprosthetic reconstruction, which resulted in an excellent outcome with no local recurrence or metastasis at 5-year follow-up. Similarly, the other case, a 42-year-old male with primary chondrosarcoma of humeral shaft of 2 years' duration, was successfully treated with total humeral excision followed by an endoprosthetic reconstruction. He also achieved an excellent functional outcome and resumed his job 1 year postoperatively. At 5 years' follow-up, there was no local recurrence or distal metastasis in this case too. These two cases of malignant lesions of femur and humerus were unique in many ways and gave a lot of insights into the diagnosis and management of rare malignancies of long bones.