Muva nje, uLiu Hucheng, umqondisi womnyango we-Bone and Soft Tissue Oncology eSibhedlela Esihlanganisiwe Sokuqala saseNyuvesi yaseNanchang, uqedele "ukususwa kwesimila se-pelvic + i-sacral osteotomy + indawo ye-pelvic + esikhundleni se-hip + i-lumbar pedicle screw fixation yangaphakathi" nge-LDK eyenziwe ngokwezifiso ye-pelvic prosthesis. , nokuhlinzwa kwahamba kahle.
Isiguli sathunyelwa esibhedlela sangaphandle ngenxa yobuhlungu obuphindaphindiwe bokubuyela emuva kanye nokungahambi kahle.Ngemva kokuphothula ukuhlolwa okuhlobene ne-hip, isiguli sasikisela ukuthi kungenzeka ukuthi i-osteo-malignant lesion, kodwa akazange ayinake, bese izimpawu zakhe zobuhlungu ziba zimbi kakhulu futhi ukuhamba kwakhe kulinganiselwe.Sabe sesifika isiguli eMnyangweni we-Bone and Soft Tissue Oncology we-First Affiliated Hospital yaseNanchang University ukuze sithole ukwelashwa.
Ngemva kokungeniswa esibhedlela nokuphothula i-pelvic bone biopsy, isiguli kwatholakala ukuthi sine-osteosarcoma.Ngemva kokuba uhlelo lokuhlinza oluphelele lwenziwe ngokuhlanganyela iminyango eminingi futhi ukulungiswa kwangaphambi kokuhlinzwa sekuqediwe, uMqondisi uLiu Hu Cheng ithimba lenze “i-pelvic tumor resection + i-sacral osteotomy + indawo ye-pelvic + esikhundleni se-hip + i-lumbar arch screw fix yangaphakathi” yesiguli.
Incazelo:
Isiguli, owesifazane, oneminyaka engama-52
Isikhalazo:
Ngaphezu kwezinyanga ezi-3 ngemuva kokwelashwa ngamakhemikhali kwe-pelvic bone osteosarcoma
Umlando wamanje wezokwelapha:
Isiguli sakhononda ngokuthi ngo-2022-10, kwakungekho imbangela ecacile yobuhlungu obuphansi obuphindaphindiwe kanye nokungahambi kahle, ngokubuhlungu nokuvuvukala, okuhambisana nobuhlungu kwesokunxele esingaphansi, esisesinqeni sesokunxele, kwesokunxele esingezansi, ohlangothini olungemuva. ethangeni, ohlangothini olungemuva lwethole ukuya onyaweni lwesokunxele, ukuba ndikindiki phansi onyaweni lwesokunxele, ubuhlungu banda ngemva kokuma nokuhamba isikhathi eside, futhi babungase bukhululeke lapho uphumula, lapho kunganakwa khona, bese izimpawu zobuhlungu zaqala ukwanda futhi zangakwazi ukuhamba.
I-MRI yasikisela: 1) isignali engavamile yethambo le-iliac kwesokunxele, kucabangela ukuthi kungenzeka kube nokulimala okubi;2) uketshezi oluncane endaweni ehlangene yenyonga yesokunxele.Akukho ukwelashwa okukhethekile okwanikezwa, futhi manje isiguli sase singeniswe esibhedlela ukuze sithole ukwelashwa okwengeziwe.
Ukuxilongwa komtholampilo:
Ukwemukelwa kwe-“Post-chemotherapy myelosuppression”
Inqubo ehlongozwayo “i-pelvic tumor resection + sacral osteotomy + pelvic replacement + hip replacement + fixation yangaphakathi nge-lumbar pedicle screw”
Izifanekiso zithunyelwe ukuze zihlolwe:
Isimila se-pelvic esingakwesobunxele sathunyelwa ukuze sihlolwe: izicubu zethambo elingamile, usayizi 19.5X17X9 cm, okunamathiselwe izicubu zemisipha, usayizi 16.5X16X3.5 cm, ukusika izigaba eziningi, 1.5 cm ukusuka emngceleni we-cautery, inqwaba yabonwa esicutshini somzimba. , usayizi 8X6.5X4.5 cm, okumpunga-bomvu, ukuqina, futhi akucaciswanga kahle phakathi kwendawo okugxilwe kuyo nezicubu zethambo.
I-Left sciatic nerve tumor: izicubu ezingamile ezimpunga ezibomvu, usayizi 9.5X3X3m, grey-white grey-red eliqinile endaweni esikiwe.
Nge-Microscopically, isimila sabonisa ukusatshalaliswa kwe-lamellar okuqinile, ehlasela i-fibrofat ye-peripheral, izicubu eziguquguqukayo nezicubu zezinzwa, ezinamangqamuzana amise ngendlela engavamile, i-nucleoli esobala, ukubona kalula i-schizophrenia yenuzi, ama-heterotypes asobala kanye ne-necrosis eningi.
Ukuxilongwa kwe-Pathologic:
(I-pelvis yesokunxele) Kuhlanganiswe nomtholampilo, izithombe kanye nomlando, kwakuhambisana nempendulo ngemva kokwelashwa ngamakhemikhali kwe-osteosarcoma yezinga eliphezulu (uhlobo oluvamile).
I-Huvos grading: ibanga II (i-chemotherapy esebenza kancane,>50% i-tumor tissue necrosis, izicubu zesimila esisindayo).
Imajini ye-tissue cautery: akukho ukubandakanyeka kwesilonda okubonwayo.
(i-left sciatic nerve) ukubandakanyeka kwesilonda esibonakalayo: Amanye ama-lymph nodes angu-2 abonisiwe, akukho metastasis ebonwe (0/2) I-Immunohistochemistry ibonisa: CK(-)；Vimentin(3+);Ki-67(75%+);SATB2(+) +
Ukuhlela ukuhlinzwa:
Ukukhishwa kwe-pelvic tumor + i-sacral osteotomy + indawo ye-pelvic + esikhundleni se-hip + ukulungiswa kwangaphakathi kwe-lumbar pedicle
Ngaphambi kokuhlinzwa
Ngemuva kokuhlinzwa
Udokotela Ohlinzayo Isingeniso
UProf. Hucheng Liu
Isibhedlela Esihlangene Sokuqala saseNanchang University Orthopedic Hospital
Induna, uMnyango Wezamathambo Nezicubu Ezithambile Oncology
Udokotela Oyinhloko, UProfesa Ohlangene, umphathi we-Master's
Umqondisi we-Bone and Soft Tissue Tumor Group, Igatsha Lamathambo, i-Jiangxi Medical Association
IPhini likaSihlalo weKomidi le-Bone and Soft Tissue Tumor ye-Jiangxi Physicians Association Orthopedic Branch
Isikhathi sokuthumela: Apr-26-2023