[Peripelvic tumors: approach and management]

The peripelvic area consists of the bony pelvis, hip joints and adjacent mesenchymal soft tissues. Malignant lesions in this area present unique diagnostic and therapeutic problems, in particular when tumor removal is involved. Between 1986 and 1988 we treated 7 females and a male, aged 8-75 years, for malignant tumors of this area. Diagnoses (histologic) included 4 cases of malignant fibrous histiocytoma, a malignant schwannoma, a Ewing sarcoma, a chondrosarcoma, and an osteosarcoma. Operations included marginal resection (4 cases), radical resection and reconstruction (2), radical resection (1), and modified hemipelvectomy (2). Adjuvant therapy consisted of radiotherapy in 1 case, chemotherapy in 2, and a combination of both in another 2. A patient who underwent radical resection and reconstruction of his left hemipelvis and hip joint died of local infection that progressed to generalized sepsis 2 months after operation. 2 patients died of recurrent disease, 3 and 30 months, respectively, after primary therapy. 1 died of myocardial infarction 20 months after the first and 3 months after the last of a series of marginal resections. 3 patients are alive and well 3-24 months following their first operation, and the fourth is doing well 24 months following first operation and 23 months after resection of lung metastases. Soft tissue sarcomas and osteosarcomas are the most frequent malignant tumors encountered in the pelvis and peripelvic areas. Their varying grades of malignancy and metastatic potential influence the approach on the one hand, while invalidity and compromised quality of life associated with tumor resection, influence it on the other.(ABSTRACT TRUNCATED AT 250 WORDS)