Total Claviculectomy as Treatment of Clavicular Ewing's Sarcoma: a Case Report and Literature Review
10.3760/cma.j.issn.0253-2352.2018.10.008
- VernacularTitle:全锁骨切除治疗锁骨尤文肉瘤一例并文献复习
- Author:
Yu CHEN
1
;
Xiuchun YU
;
Ming XU
;
Kai ZHENG
Author Information
1. 250031,济南军区总医院骨病科
- Keywords:
Sarcoma,Ewing;
Clavicle;
Surgical procedures;
Bone remodeling;
Recovery of function
- From:
Chinese Journal of Orthopaedics
2018;38(10):620-626
- CountryChina
- Language:Chinese
-
Abstract:
Objective To analyze the efficacy of total claviculectomy in the treatment of Ewing's sarcoma and to discuss the impact of clavicular reconstruction on the outcome.Methods The clinical records of a 13-year-old male patient with left clavicular Ewing's sarcoma were reviewed.The subject received 2 cycles (at an interval of 2 weeks) of neoadjuvant chemotherapy comprising cisplatin 120 mg/m2 (1 d),adriomycin 30 mg/m2 (3 d),and ifosfamide 2.0 g/m2 (5 d).Total claviculectomy was carried out without clavicular reconstruction and the patient underwent 9 cycles of subsequent chemotherapy.The appearance and function of the operated limb,radiological examinations of the surgical site,ECT bone scans and pulmonary CT were followed up.The literatures regarding the total and subtotal excision of the clavicle were reviewed to investigate the importance of clavicular reconstruction.Results After 23-months of follow-up,the patient was subjectively free of limb function compromise.Physical examinations indicated drooping of the operated shoulder by 2 cm,whereas the appearance was similar between both shoulders.Functionality of the operated limb was recovered.The motion of the left shoulder:abduction 90°,adduction 40°,anterior flexion 90°,extension 45°,internal rotation 80°,external rotation 60°,and no restriction of limb elevation.Manual muscle strength tests showed V/V muscle strength of the operated limb.American Shoulder and Elbow Surgeons' form (ASES) and Musculoskeletal Tumor Society (MSTS) score were 96 and 30,respectively.Postoperative X-ray films demonstrated mild thoracic scoliosis.The patient did not appear recurrence and metastasis.Conclusion Total claviculectomy is efficacious for treating clavicular Ewing's sarcoma.Clavicular reconstruction may not be imperative for treatment of clavicular malignancy because of the increased technical difficulty and great risk of complications.
