Chondrosarcoma
A 52 year old man is having pain in his right shoulder
Step 4: Management
Effective management lorem ipsum dolor sit amet, consectetur adipiscing elit. Aliquam nibh est, lobortis eget est quis, hendrerit aliquet urna. Morbi consectetur lacus non metus mollis, porta rut.
What are the recommended treatment principles for chondrosarcoma?
For low grade chondrosarcoma the primary recommendation is surgical. A resection of the lesion with wide margins (i.e. a cuff of normal tissue completely encasing the lesion) gives the best chance of local and systemic control.. In some cases this is no anatomically feasible and radiation treatment, such as with proton therapy, is used as an adjunct. Chemotherapy is generally of little effect. This surgery is best completed by a surgeon with subspecialist training and experience in orthopaedic oncology
For this patient we discussed extensively whether we would need to resected any component of the shoulder joint itself. We felt that we would be able to mobilise the soft tissue on the surface of the tumour, then dislocate the shoulder and perform a joint-preserving resection. The following intra-operative images indicate the technique we used to remove the tumour.
How would you reconstruct this defect?
We chose to use an allograft strut from a tibia and hold this in place with 2 screws. We then bypassed the whole structure with a locking plate. This might have been overkill to some extent with the fixation, but we wanted him to be able to return to activity as quickly as possible