Kutshanje, u-Liu Hucheng, umlawuli weSebe le-Bone kunye ne-Soft Tissue Oncology kwiSibhedlele sokuQala esiBambiseneyo seYunivesithi yaseNanchang, wagqiba "i-pelvic tumor resection + i-sacral osteotomy + indawo ye-pelvic + indawo ye-hip + i-lumbar pedicle screw fixation yangaphakathi" kunye ne-LDK eyenziwe ngokwezifiso ze-pelvic prosthesis. , kwaye utyando lwahamba kakuhle.
Isigulane sathunyelwa kwisibhedlele sangaphandle ngenxa yeentlungu eziphindaphindiweyo kunye nokungahambi kakuhle.Emva kokugqiba iimviwo ezinxulumene ne-hip, isigulane sacetyiswa ukuba i-osteo-malignant lesion inokwenzeka, kodwa ayizange inikele ingqalelo kuyo, kwaye emva koko iimpawu zakhe zentlungu zanda kwaye ukuhamba kwakhe kwakulinganiselwe.Emva koko isigulane safika kwiSebe le-Bone kunye ne-Soft Tissue Oncology yeSibhedlele sokuqala esiBambiseneyo seYunivesithi yaseNanchang unyango.
Emva kokungeniswa esibhedlele kunye nokugqiba i-pelvic bone biopsy, isigulane safunyaniswa ukuba sine-osteosarcoma.Emva kokuba isicwangciso sotyando esicokisekileyo saqulunqwa ngokudibeneyo ngamasebe amaninzi kunye nokulungiswa kwangaphambili kwagqitywa, uMlawuli uLiu Hu Cheng iqela lenze "i-pelvic tumor resection + i-sacral osteotomy + indawo ye-pelvic + indawo ye-hip + i-lumbar arch screw ukulungiswa kwangaphakathi" kwisigulane.
Inkcazo:
Isigulane, umfazi, iminyaka engama-52 ubudala
Isikhalazo:
Ngaphezulu kweenyanga ezi-3 emva kwechemotherapy ye-pelvic bone osteosarcoma
Imbali yonyango yangoku:
Isigulana sakhalaza ukuba kwi-2022-10, kwakungekho sizathu esicacileyo sentlungu ephantsi ephindaphindiweyo kunye nokungahambi kakuhle, kunye nobuhlungu kunye nokuvuvukala, kunye nentlungu ephantsi kwesobunxele, ebekwe kwi-hip ekhohlo, kwicala lasekhohlo, kwicala elingasemva. ethangeni, kwicala elingasemva lethole ukuya kunyawo lwasekhohlo, ukuba ndindisholo emazantsi onyawo lwasekhohlo, iintlungu zanda emva kokuma nokuhamba ixesha elide, kwaye zinokukhululeka xa ziphumla, apho kungekho ngqalelo ihlawulweyo, kwaye emva koko iimpawu zentlungu zaqala ukwanda kwaye azikwazanga ukuhamba.
I-MRI iphakamise: i-1) isignali engaqhelekanga yethambo le-iliac ekhohlo, ecinga ukuba kunokwenzeka ukuba kubekho isilonda esibi;2) umthamo omncinci wolwelo kwindawo ye-hip ekhohlo.Akuzange kwenziwe unyango olukhethekileyo, yaye ngoku umguli walaliswa esibhedlele ukuze afumane unyango olungakumbi.
Ukuxilongwa kweklinikhi:
"I-post-chemotherapy myelosuppression" yokwamkelwa
Inkqubo ecetywayo yi "pelvic tumor resection + sacral osteotomy + pelvic replacement + hip replacement + fixation yangaphakathi nge-lumbar pedicle screw"
Iisampulu ezithunyelwe ukuba zihlolwe:
Ithumba le-pelvic lasekhohlo lathunyelwa ukuba lihlolwe: izicubu zethambo ezingalungiswanga, ubukhulu be-19.5X17X9 cm, kunye nezicubu zomzimba ezincanyathiselwe, ubukhulu be-16.5X16X3.5 cm, ulwahlulo olunamacandelo amaninzi, i-1.5 cm ukusuka kumda we-cautery, ubunzima bubonwe kwizicubu zomzimba. , ubungakanani 8X6.5X4.5 cm, ngwevu-bomvu, iqinile, kwaye ibonakaliswe kakubi phakathi kwendawo ekugxilwe kuyo kunye nethambo lethambo.
Ithumba le-nerve ye-sciatic yasekhohlo: ithishu engwevu-ebomvu engabunjwanga, ubungakanani be-9.5X3X3m, ingwevu-engwevu-ebomvu iqinile kumphezulu osikiweyo.
Microscopically, ithumba wabonisa ukwabiwa lamellar eyomeleleyo, ehlasela peripheral fibrofat, izihlunu ezinqamlezayo kunye nemithambo luvo, kunye iiseli imilo ngokungaqhelekanga, nucleoli ezicacileyo, lula ukubona schizophrenia yenyukliya, heterotypes ezicacileyo kunye necrosis eninzi.
Ukuxilongwa kwePathologic:
(I-pelvis yasekhohlo) Idibaniswe neklinikhi, ukucinga kunye nembali, yayihambelana nempendulo emva kwe-chemotherapy ye-high-grade osteosarcoma (uhlobo oluqhelekileyo).
Ukuhlelwa kweHuvos: ibakala II (ichemotherapy esebenzayo kancinci,>50% ye-tumor tissue necrosis, ithumba elisindayo kwithishu).
Umda we-tissue cautery: akukho kubandakanyeka kwesilonda kubonwe.
(i-nerve ye-sciatic yasekhohlo) ukubandakanyeka kwe-lesion ebonakalayo: I-2 enye i-lymph nodes ibonwe, akukho metastasis ibonwayo (0/2) i-Immunohistochemistry ibonisa: CK (-) ； Vimentin (3 +) ；Ki-67 (75% +) ;SATB2 (+) ; I-INV3 (+); I-MDM2 (+); p16 (+); I-S-100 (); I-Headmis (); I-CD68 (); I-CD68 (); I-DED68 (); I-CD68 (-); I-CD68 (); i-cd68 (); i-cd68 (); I-CD68 (); i-cd68 (); i-cd68 (); i-cd68 (); i-cd68 (); I-CD68
Isicwangciso sotyando:
Ukwenziwa kwe-pelvic tumor resection + i-sacral osteotomy + indawo ye-pelvic replacement + indawo yenyonga + i-lumbar pedicle screw ukulungiswa kwangaphakathi
Utyando lwangaphambili
Emva koqhaqho
Intshayelelo yoGqirha
UProf. Hucheng Liu
Isibhedlele sokuqala esiManyaniswa neSibhedlele seYunivesithi yaseNanchang ye-Orthopedic Hospital
INtloko, iSebe le-Bone kunye ne-Soft Tissue Oncology
Ugqirha oyiNtloko, uNjingalwazi oDityaniswayo, umphathi we-Master
UMlawuli we-Bone kunye ne-Soft Tissue Tumor Group, i-Orthopedic Branch, i-Jiangxi Medical Association
Usekela Sihlalo weKomiti yeBone kunye neSoft Tissue Tumor yeJiangxi Gqirha Association Orthopedic Branch
Ixesha lokuposa: Apr-26-2023