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Preserved walking function without postoperative reconstruction for pelvic Ewing's sarcoma: a case report.

Kazunori Nakayama1, Seiji Shimomura1, Toshiharu Shirai2

  • 1Department of Orthopaedics, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajii-Cho, Kawaramachi-Hirokoji, Kamigyo-Ku, Kyoto, 602-8566, Japan.

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This study reports a successful treatment for a pediatric patient with metastatic pelvic Ewing sarcoma. Avoiding pelvic reconstruction facilitated early chemotherapy and reduced infection risk, enabling a stable gait post-surgery.

Keywords:
Ewing’s sarcomaInfectionPelvicPelvic ring reconstruction

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Area of Science:

  • Pediatric Oncology
  • Skeletal Tumors
  • Surgical Oncology

Background:

  • Ewing sarcoma is a rare bone cancer primarily affecting children and adolescents.
  • Pelvic Ewing sarcoma with metastasis has a poor prognosis and high risk of infection.
  • Multidisciplinary treatment is crucial for managing this aggressive cancer.

Observation:

  • A 14-year-old boy presented with advanced left iliac Ewing sarcoma and multiple metastases.
  • Neoadjuvant chemotherapy significantly reduced tumor size.
  • Surgical resection was performed without pelvic ring reconstruction.

Findings:

  • The surgical approach prioritized early postoperative chemotherapy and minimized infection risk.
  • Despite abductor muscle removal, the patient achieved a stable gait.
  • This strategy focused on functional preservation and reducing complications.

Implications:

  • This case demonstrates a viable approach for managing complex pelvic Ewing sarcoma.
  • Avoiding pelvic reconstruction may improve outcomes by enabling timely adjuvant therapy.
  • Functional recovery and reduced morbidity are achievable with tailored surgical strategies.