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Prabowo Y, Fajrin Armin M, Alhuraiby SS, Canintika AF. Surgical techniques for medial clavicular tumors: A report of 3 cases. Int J Surg Case Rep 2023; 106:108115. [PMID: 37060765 PMCID: PMC10139884 DOI: 10.1016/j.ijscr.2023.108115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2023] [Revised: 03/29/2023] [Accepted: 03/29/2023] [Indexed: 04/09/2023] Open
Abstract
INTRODUCTION AND IMPORTANCE Clavicular tumors are rare, consisting of <1 % of all skeletal tumors. In this series, we described our experience of treating medial clavicular tumors. CASE PRESENTATION We treated three patients with medial clavicle tumors at a national tertiary referral hospital in Jakarta, Indonesia. The patients were treated with wide excision following bony reconstruction from fibular bone and one patient was treated by marginal excision. Each patient was treated by surgery and one patient underwent reconstruction using non-vascularized fibular graft and composite using bone cement. CLINICAL DISCUSSION All patients resulted in restoration of symmetry of the lower neck and upper chest and no post-surgical complication. Based on these cases above and the extension of tumor, we recommend medial clavicle tumor resection classification divided into three type to decide which type of surgical procedure that should be performed. In our report, all patients resulted in restoration of symmetry of the lower neck and upper chest and no post-surgical complication. CONCLUSION Clavicle resection in management of medial third clavicle tumor is technically demanding. We proposed three types of clavicular resection based on tumor extension. The surgical technique of medial end clavicle in this patient resulted in tumor free margin of medial clavicular, medial scapula, and lateral scapular incision. Reconstruction surgery following clavicle resection can be done in order to restore symmetry of the lower neck and upper chest, protect nearby neurovascular bundle, and rarely associated with significant shoulder function loss.
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Affiliation(s)
- Yogi Prabowo
- Department of Orthopaedics and Traumatology, Faculty of Medicine, Universitas Indonesia-Cipto Mangunkusumo Hospital, Jakarta, Indonesia
| | - M Fajrin Armin
- Department of Orthopaedics and Traumatology, Faculty of Medicine, Universitas Indonesia-Cipto Mangunkusumo Hospital, Jakarta, Indonesia
| | - Sammy Saleh Alhuraiby
- Department of Orthopaedics and Traumatology, Faculty of Medicine, Universitas Indonesia-Cipto Mangunkusumo Hospital, Jakarta, Indonesia
| | - Anissa Feby Canintika
- Department of Orthopaedics and Traumatology, Faculty of Medicine, Universitas Indonesia-Cipto Mangunkusumo Hospital, Jakarta, Indonesia.
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Arunwatthanangkul P, Piyabenjarad P, Wisitthipakdeekul S, Chobpenthai T. Innovative method with two-stage surgery for Ewing sarcoma with personalized distal clavicle reconstruction: A case report and diagnosis review. Front Oncol 2023; 13:1134324. [PMID: 37064107 PMCID: PMC10090420 DOI: 10.3389/fonc.2023.1134324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Accepted: 03/14/2023] [Indexed: 03/31/2023] Open
Abstract
A 13-year-old boy presented with a growing lump on his left clavicle for 5 months. The plain radiograph revealed an osteolytic mass with aggressive periosteal reaction, suggesting a malignant lesion. The results of advanced imaging and histopathological examinations revealed that the patient had Ewing sarcoma without metastasis. The two-stage surgery was as follows: resection–observation–reconstruction. The underlying rationale was that Ewing sarcoma has a high recurrence. After 2 years of resection, the patient had remission, and he currently has a personal 3D-printed titanium implant with intact shoulder function.
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Li Z, Zou C, Lu M, Zhang Y, Gong T, Wang J, Luo Y, Zhou Y, Min L, Tu C. Case report: Intraosseous hemangioma of the lateral clavicle treated by surgical resection and reconstructed by three-dimensional-printed personalized prosthesis. Front Bioeng Biotechnol 2023; 10:1085674. [PMID: 36698635 PMCID: PMC9868392 DOI: 10.3389/fbioe.2022.1085674] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Accepted: 12/23/2022] [Indexed: 01/11/2023] Open
Abstract
Background: Intraosseous hemangiomas occurring the clavicle is uncommon. Reconstruction of the clavicle is suggested to maintain the normal shoulder joint function and prevent adverse outcomes. Complex anatomy shape of the clavicle remains a great challenge for prosthetic reconstruction of the clavicle. Case presentation: A 37-year-old female with no conclusive history of trauma presented with progressive mass at the right lateral clavicle for 5 years. The patient was treated by surgical resection and reconstructed by three-dimensional-printed personalized prosthesis. Postoperatively radiographic examinations revealed a good position of the prosthesis, neither breakage nor loosening was detected. The right shoulder mobility returned to approximate level of preoperative shoulder 2 months after surgical reconstruction, with the range of motion of flexion 80°, extension 40°, abduction 80°, adduction 30°, external rotation 55°, and internal rotation 60°. The patient maintained the normal shoulder function during the 48 months follow-up period. There was no pain during shoulder motion. The Musculoskeletal Tumor Society Score (MSTS) score was 29 and the Functional Evaluation Form recommended by the American Shoulder and Elbow Surgeons (ASES) score was 95. Conclusion: 3D-printed personalized prosthesis is a good option to reconstruct the lateral clavicle bone defect and restore the shoulder support structure. It maintains the normal shoulder joint function and avoids adverse effects on daily activities after claviculectomy.
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Affiliation(s)
- Zhuangzhuang Li
- Department of Orthopedics, Orthopaedic Research Institute, West China Hospital, Sichuan University, Chengdu, China,Model Worker and Craftsman Talent Innovation Workshop of Sichuan province, Chengdu, Sichuan, China
| | - Chang Zou
- Department of Orthopedics, Orthopaedic Research Institute, West China Hospital, Sichuan University, Chengdu, China
| | - Minxun Lu
- Department of Orthopedics, Orthopaedic Research Institute, West China Hospital, Sichuan University, Chengdu, China,Model Worker and Craftsman Talent Innovation Workshop of Sichuan province, Chengdu, Sichuan, China
| | - Yuqi Zhang
- Department of Orthopedics, Orthopaedic Research Institute, West China Hospital, Sichuan University, Chengdu, China,Model Worker and Craftsman Talent Innovation Workshop of Sichuan province, Chengdu, Sichuan, China
| | - Taojun Gong
- Department of Orthopedics, Orthopaedic Research Institute, West China Hospital, Sichuan University, Chengdu, China,Model Worker and Craftsman Talent Innovation Workshop of Sichuan province, Chengdu, Sichuan, China
| | - Jie Wang
- Department of Orthopedics, Orthopaedic Research Institute, West China Hospital, Sichuan University, Chengdu, China,Model Worker and Craftsman Talent Innovation Workshop of Sichuan province, Chengdu, Sichuan, China
| | - Yi Luo
- Department of Orthopedics, Orthopaedic Research Institute, West China Hospital, Sichuan University, Chengdu, China,Model Worker and Craftsman Talent Innovation Workshop of Sichuan province, Chengdu, Sichuan, China
| | - Yong Zhou
- Department of Orthopedics, Orthopaedic Research Institute, West China Hospital, Sichuan University, Chengdu, China,Model Worker and Craftsman Talent Innovation Workshop of Sichuan province, Chengdu, Sichuan, China
| | - Li Min
- Department of Orthopedics, Orthopaedic Research Institute, West China Hospital, Sichuan University, Chengdu, China,Model Worker and Craftsman Talent Innovation Workshop of Sichuan province, Chengdu, Sichuan, China,*Correspondence: Li Min, ; Chongqi Tu,
| | - Chongqi Tu
- Department of Orthopedics, Orthopaedic Research Institute, West China Hospital, Sichuan University, Chengdu, China,Model Worker and Craftsman Talent Innovation Workshop of Sichuan province, Chengdu, Sichuan, China,*Correspondence: Li Min, ; Chongqi Tu,
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Smolanka II, Movchan OV, Bagmut IY, Sheremet MI, Kolisnyk IL, Dosenko IV, Lyashcnko AO, Ivankova OM, Loboda AD, Shidlovskyi OV. Breast cancer relapses considering molecular biological characteristics. J Med Life 2023; 16:70-75. [PMID: 36873133 PMCID: PMC9979183 DOI: 10.25122/jml-2022-0189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Accepted: 07/28/2022] [Indexed: 03/07/2023] Open
Abstract
We aimed to analyze the frequency of breast cancer relapses and their relationship with molecular and biological tumor characteristics. We studied 6,136 breast cancer patients, including 146 with relapses (Group 1) and 455 without relapses (Group 2). We divided the patients based on age, menstrual function, disease stage, histology form and grade, and molecular-biological subtype. The 5-year relapse-free rate for Group 1 was longer for Lum A and TN subtypes (60% and 40%, respectively) but shorter for Lum B and HER-2/neu-amplified subtypes (38% and 31%, respectively). Disease stage, tumor histology, and grade did not significantly affect relapse frequency in these patients. Relapses were more common in premenopausal patients and the Lum B subtype.
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Nistor CE, Ciuche A, Cucu AP, Nitipir C, Slavu C, Serban B, Cursaru A, Cretu B, Cirstoiu C. Management of Lung Cancer Presenting with Solitary Bone Metastasis. MEDICINA (KAUNAS, LITHUANIA) 2022; 58:medicina58101463. [PMID: 36295624 PMCID: PMC9612355 DOI: 10.3390/medicina58101463] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/21/2022] [Revised: 10/09/2022] [Accepted: 10/13/2022] [Indexed: 11/07/2022]
Abstract
Lung neoplasm is the main cause of cancer-related mortality, and bone metastasis is among the most common secondary tumors. The vast majority of patients also present with multiple bone metastases, which makes systemic and adjuvant pain therapy preferable to surgery. The optimal approach for a resectable non-small-cell lung tumor that also presents a unique, resectable bone metastasis is not fully established. The number of papers addressing this subject is small, and most are case reports; nevertheless, survival rates seem to increase with radical surgery. The sequencing of local versus systemic treatment should always be discussed within the multidisciplinary team that will choose the best approach for each patient. As targeted systemic therapies become more accessible, radical surgery, together with existing reconstructive methods, will lead to an increase in life expectancy and a better quality of life.
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Affiliation(s)
- Claudiu-Eduard Nistor
- Department Thoracic Surgery, Dr. Carol Davila Central Military Emergency University Hospital, 010825 Bucharest, Romania
| | - Adrian Ciuche
- Department Thoracic Surgery, Dr. Carol Davila Central Military Emergency University Hospital, 010825 Bucharest, Romania
| | - Anca Pati Cucu
- Department Thoracic Surgery, Dr. Carol Davila Central Military Emergency University Hospital, 010825 Bucharest, Romania
| | - Cornelia Nitipir
- Department of Medical Oncology, Carol Davila University Medicine & Pharmacy, Elias University Emergency Hospital, 011468 Bucharest, Romania
| | - Cristina Slavu
- Department of Medical Oncology, Carol Davila University Medicine & Pharmacy, Elias University Emergency Hospital, 011468 Bucharest, Romania
| | - Bogdan Serban
- Department Orthopedic & Traumatology, Carol Davila University Medicine & Pharmacy, University Emergency Hospital, 050098 Bucharest, Romania
| | - Adrian Cursaru
- Department Orthopedic & Traumatology, Carol Davila University Medicine & Pharmacy, University Emergency Hospital, 050098 Bucharest, Romania
| | - Bogdan Cretu
- Department Orthopedic & Traumatology, Carol Davila University Medicine & Pharmacy, University Emergency Hospital, 050098 Bucharest, Romania
- Correspondence:
| | - Catalin Cirstoiu
- Department Orthopedic & Traumatology, Carol Davila University Medicine & Pharmacy, University Emergency Hospital, 050098 Bucharest, Romania
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Multispecialty surgical management of large clavicular tumor: A case report. Int J Surg Case Rep 2022; 97:107375. [PMID: 35849901 PMCID: PMC9403025 DOI: 10.1016/j.ijscr.2022.107375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2022] [Revised: 06/26/2022] [Accepted: 06/26/2022] [Indexed: 02/07/2023] Open
Abstract
INTRODUCTION Primary and metastatic malignancies of the clavicle are extremely uncommon and difficult to treat. It carries a high morbidity rate. Total or partial claviculectomy is the recommended treatment option. PRESENTATION OF CASE A 59-year-old male was admitted with a large left clavicular huge mass; biopsy showed poorly differentiated adenocarcinoma. Treatment started with chemoradiotherapy followed by complete excision of the tumor surgically. DISCUSSION For treating this rare, difficult case, partial claviculectomy performed by a multispecialty team integrating three surgical skill sets: thoracic, ENT, and orthopedic surgeons, yields the best results. Clavicular carcinoma of known primary (CUP) is rare, and chemoradiotherapy showed preferable results in management. CONCLUSION MDT reviews with surgeons, radiologists, pathologists, oncologists, and radiation oncologists are required in rare and complex cases of clavicular malignancy. Multispecialty surgical involvement is required for the safe excision of clavicular tumors with appropriate oncologic margins and fewer complications.
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Gulia A, Puri A, Gupta S, Vora T, Laskar S. Functional and Oncological Outcomes of Multidisciplinary Management of Ewing's Sarcoma of Clavicle: A Single-Center Experience. South Asian J Cancer 2021; 10:138-143. [PMID: 34934757 PMCID: PMC8683259 DOI: 10.1055/s-0041-1731901] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
Abstract
Objectives Ewing's sarcoma is best treated using a multidisciplinary approach. We discuss the functional and oncological outcomes of clavicular Ewing's sarcoma which has been sparsely reported in literature. Materials and Methods We retrospectively evaluated patients who underwent resections for Ewing's sarcoma of clavicle from January 2002 to December 2017. The study end points were locoregional recurrence free survival (LRFS), disease-free survival (DFS), and overall survival (OS) at 3 and 5 years, and functional outcomes measured by Musculoskeletal Tumor Society (MSTS) scores. Statistical Analysis The LRFS, DFS, and OS were calculated and analyzed using the Kaplan-Meier method and log-rank test. Results Data of 21 patients (male: 12, female: 9) was analyzed with a mean age [range] of 15.3 [6-40] years. Total clavicle excision was done in 62% (13 of 21) while 38% ( n = 8) had partial resections. Radiotherapy was administered in 15 patients (71.5%). At a median follow-up of 42 months (range: 7-198), data of 20 patients was available for follow-up. Ten patients died (due to disease: nine, other reasons: One), eight are disease free and alive, one had metastasectomy on recurrence and is disease free and, one patient is alive with disease and on palliative chemotherapy. The LRFS, DFS, and OS were 95, 59, 65% and 95, 47, 59% at 3 and 5 years, respectively. The functional evaluation done for nine patients who are free of disease showed a mean MSTS score of 29 (range: 27-30; total clavicle excision: 28.5, partial clavicle excision: 29.5). Conclusion Patients with Ewing's sarcoma of the clavicle who underwent resection without reconstruction have acceptable local control rates and excellent functional outcomes.
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Affiliation(s)
- Ashish Gulia
- Department of Surgical Oncology, Tata Memorial Hospital, and Homi Bhabha National Institute (HBNI), Mumbai, Maharashtra, India
| | - Ajay Puri
- Department of Surgical Oncology, Tata Memorial Hospital, and Homi Bhabha National Institute (HBNI), Mumbai, Maharashtra, India
| | - Srinath Gupta
- Department of Surgical Oncology, Tata Memorial Hospital, and Homi Bhabha National Institute (HBNI), Mumbai, Maharashtra, India
| | - Tushar Vora
- Department of Medical Oncology, Tata Memorial Hospital, and Homi Bhabha National Institute (HBNI), Mumbai, Maharashtra, India
| | - Siddhartha Laskar
- Department of Radiation Oncology, Tata Memorial Hospital, and Homi Bhabha National Institute (HBNI), Mumbai, Maharashtra, India
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Chen C, Yin Y, Xu H, Li Z, Wang F, Chen G. Personalized three-dimensional printed polyether-ether-ketone prosthesis for reconstruction after subtotal removal of chronic clavicle osteomyelitis: A case report. Medicine (Baltimore) 2021; 100:e25703. [PMID: 33907152 PMCID: PMC8083998 DOI: 10.1097/md.0000000000025703] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Accepted: 04/08/2021] [Indexed: 11/27/2022] Open
Abstract
RATIONALE Three-dimensional (3D) printing has attracted wide attention for its potential and abilities in the assistance of surgical planning and the development of personalized prostheses. We herewith report a unique case of chronic clavicle osteomyelitis treated with a two-stage subtotal clavicle reconstruction using a 3D printed polyether-ether-ketone (PEEK) prosthesis. PATIENT CONCERNS A 23-year-old Chinese female presented to our clinic complaining about a progressive pain of her right clavicle for about 1 year. DIAGNOSES Chronic clavicle osteomyelitis confirmed by percutaneous biopsy and lesion biopsy. INTERVENTIONS This patient accepted a long-term conservative treatment, which did not gain satisfactory outcomes. Thus, a subtotal removal and two-stage reconstruction of the right clavicle with a 3D-printed polyether-ether-ketone prosthesis stabilized by screw fixation system was performed. OUTCOMES At 2-year follow-up, complete pain relief and satisfactory functional recovery of her right shoulder were observed. LESSONS Personalized 3D printed prosthesis is an effective and feasible method for reconstruction of complex bone defects.
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Affiliation(s)
- Chang Chen
- Department of Orthopaedics, The Affiliated Hospital of Southwest Medical University
- Sichuan Province Laboratory of Orthopaedic Engineering, Luzhou City, Sichuan Province
| | - Yiran Yin
- Department of Orthopaedics, The Affiliated Hospital of Southwest Medical University
- Sichuan Province Laboratory of Orthopaedic Engineering, Luzhou City, Sichuan Province
| | - Huan Xu
- Department of Orthopaedics, The Affiliated Hospital of Southwest Medical University
- Sichuan Province Laboratory of Orthopaedic Engineering, Luzhou City, Sichuan Province
| | - Zhong Li
- Department of Orthopaedics, The Affiliated Hospital of Southwest Medical University
- Sichuan Province Laboratory of Orthopaedic Engineering, Luzhou City, Sichuan Province
| | - Fuyou Wang
- Center for Joint Surgery, Southwest Hospital, Third Military Medical University, Chongqing, China
| | - Ge Chen
- Department of Orthopaedics, The Affiliated Hospital of Southwest Medical University
- Sichuan Province Laboratory of Orthopaedic Engineering, Luzhou City, Sichuan Province
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