Laura Saenz* and Orestes Tamayo
Volume3-Issue5
Dates: Received: 2022-05-09 | Accepted: 2022-05-14 | Published: 2022-05-15
Pages: 547-551
Abstract
Ewing Sarcoma (ES) is mainly diagnosed during the second decade of life. It often compromises the appendicular skeleton but also can affect other bones. A surgical procedure is necessary despite its good response to chemotherapeutics and radiotherapy. When planning limb-sparing procedures for the young patient, the main challenges are bone size, growth remaining, and physical demands.
Several techniques have been proposed. However, there is no gold standard procedure because many factors must be considered, and each case should be individualized. Also, the resources available change from one medical center to another and every surgeon has to deal with a different reality.
This article presents one case of a 5-year-old male patient diagnosed with ES in the diaphyseal region of the humerus. It reviews the possible surgical options for humeral reconstruction in young children with ES and discusses the challenges that surgeons might have overcome.
FullText HTML
FullText PDF
DOI: 10.37871/jbres1477
Certificate of Publication

Copyright
© 2022 Saenz L, et al. Distributed under Creative Commons CC-BY 4.0
How to cite this article
Saenz L, Tamayo O. What we would like to do vs what we can truly Achieve as Surgeons. Treatment of the Humeral Ewing Sarcoma for the Young Pediatric Patient. J Biomed Res Environ Sci. 2022 May 16; 3(5): 547-551. doi: 10.37871/jbres1477, Article ID: JBRES1477, Available at: https://www.jelsciences.com/articles/jbres1477.pdf
Subject area(s)
References
- Christopher DM. Diagnostic Histopathology of Tumors. 2021. https://tinyurl.com/5yd38hhr
- Proctor A, Brownhill SC, Burchill SA. The promise of telomere length, telomerase activity and its regulation in the translocation-dependent cancer ESFT; clinical challenges and utility. Biochim Biophys Acta. 2009 Apr;1792(4):260-274. doi: 10.1016/j.bbadis.2009.02.011. Epub 2009 Mar 2. PMID: 19264125.
- Durer S, Shaikh H. Ewing Sarcoma. StatPearls. Treasure Island (FL): StatPearls Publishing. 2022. PMID: 32644609.
- Balamuth NJ, Womer RB. Ewing's sarcoma. Lancet Oncol. 2010 Feb;11(2):184-192. doi: 10.1016/S1470-2045(09)70286-4. PMID: 20152770.
- Hannonen J, Hyvönen H, Korhonen L, Serlo W, Sinikumpu JJ. The incidence and treatment trends of pediatric proximal humerus fractures. BMC Musculoskelet Disord. 2019 Nov 27;20(1):571. doi: 10.1186/s12891-019-2948-7. PMID: 31775692; PMCID: PMC6882178.
- Curl LA, Warren RF. Glenohumeral joint stability. Selective cutting studies on the static capsular restraints. Clin Orthop Relat Res. 1996 Sep;(330):54-65. PMID: 8804275.
- Murphey MD, Senchak LT, Mambalam PK, Logie CI, Klassen-Fischer MK, Kransdorf MJ. From the radiologic pathology archives: ewing sarcoma family of tumors: radiologic-pathologic correlation. Radiographics. 2013 May;33(3):803-831. doi: 10.1148/rg.333135005. PMID: 23674776.
- Ebrahimpour A, Chehrassan M, Sadighi M, Azizmohammad Looha M, Karimi A, Akbari A, Raeisi A, Akbari ME. The survival and incidence rate of ewing sarcoma; a national population-based study in iran (2008-2015). Arch Bone Jt Surg. 2020 May;8(3):391-399. doi: 10.22038/abjs.2020.44095.2206. PMID: 32766398; PMCID: PMC7358229.
- Levin LS. Vascularized fibula graft for the traumatically induced long-bone defect. J Am Acad Orthop Surg. 2006;14(10 Spec No.):S175-176. doi: 10.5435/00124635-200600001-00038. PMID: 17003193.
- Migliorini F, La Padula G, Torsiello E, Spiezia F, Oliva F, Maffulli N. Strategies for large bone defect reconstruction after trauma, infections or tumour excision: A comprehensive review of the literature. Eur J Med Res. 2021;26(1):118. https://tinyurl.com/2twpc2mj
- Biazzo A, Romantini M, De Paolis M, Manfrini M, Donati D. Vascularized fibular autograft as salvage technique in failure of allograft intercalary reconstructions after tumor resections. Acta Orthop Belg. 2018 Mar;84(1):38-46. PMID: 30457498.
- Wodajo FM, Bickels J, Wittig J, Malawer M. Complex reconstruction in the management of extremity sarcomas. Curr Opin Oncol. 2003 Jul;15(4):304-312. doi: 10.1097/00001622-200307000-00005. PMID: 12874509.
- Asada N, Tsuchiya H, Kitaoka K, Mori Y, Tomita K. Massive autoclaved allografts and autografts for limb salvage surgery. A 1-8 year follow-up of 23 patients. Acta Orthop Scand. 1997 Aug;68(4):392-5. doi: 10.3109/17453679708996184. PMID: 9310047.
- Lawal YZ, Garba ES, Ogirima MO, Dahiru IL, Maitama MI, Abubakar K, Ejagwulu FS. Use of non-vascularized autologous fibula strut graft in the treatment of segmental bone loss. Ann Afr Med. 2011 Jan-Mar;10(1):25-28. doi: 10.4103/1596-3519.76571. PMID: 21311151.
- Taylor GI, Miller GD, Ham FJ. The free vascularized bone graft. A clinical extension of microvascular techniques. Plast Reconstr Surg. 1975 May;55(5):533-544. doi: 10.1097/00006534-197505000-00002. PMID: 1096183.
- O'Connor MI, Sim FH, Chao EY. Limb salvage for neoplasms of the shoulder girdle. Intermediate reconstructive and functional results. J Bone Joint Surg Am. 1996 Dec;78(12):1872-1888. doi: 10.2106/00004623-199612000-00011. PMID: 8986665.
- Panagopoulos GN, Mavrogenis AF, Mauffrey C, Lesenský J, Angelini A, Megaloikonomos PD, Igoumenou VG, Papanastassiou J, Savvidou O, Ruggieri P, Papagelopoulos PJ. Intercalary reconstructions after bone tumor resections: A review of treatments. Eur J Orthop Surg Traumatol. 2017 Aug;27(6):737-746. doi: 10.1007/s00590-017-1985-x. Epub 2017 Jun 5. PMID: 28585185.
- Kohler R, Lorge F, Brunat-Mentigny M, Noyer D, Patricot L. Massive bone allografts in children. Int Orthop. 1990;14(3):249-253. doi: 10.1007/BF00178754. PMID: 2279831.
- Sharma S, Turcotte RE, Isler MH, Wong C. Experience with cemented large segment endoprostheses for tumors. Clin Orthop Relat Res. 2007 Jun;459:54-59. doi: 10.1097/BLO.0b013e3180514c8e. PMID: 17545759.
- Wittig JC, Bickels J, Kellar-Graney KL, Kim FH, Malawer MM. Osteosarcoma of the proximal humerus: Long-term results with limb-sparing surgery. Clin Orthop Relat Res. 2002 Apr;(397):156-176. doi: 10.1097/00003086-200204000-00021. PMID: 11953608.
- Balke M, Ahrens H, Streitbürger A, Gosheger G, Hardes J. Modular endoprosthetic reconstruction in malignant bone tumors: Indications and limits. Recent Results Cancer Res. 2009;179:39-50. doi: 10.1007/978-3-540-77960-5_4. PMID: 19230533.
- Frassica FJ, Chao EY, Shives TC, Sim FH. Resection of malignant bone tumors about the shoulder. A preliminary report of reconstruction with a new modular spacer. Clin Orthop Relat Res. 1991 Jun;(267):57-64. PMID: 2044293.
- Tang X, Guo W, Yang R, Tang S, Ji T. Synthetic mesh improves shoulder function after intra articular resection and prosthetic replacement of proximal humerus. Clin Orthop Relat Res. 2015 Apr;473(4):1464-1471. doi: 10.1007/s11999-015-4139-7. Epub 2015 Jan 21. PMID: 25604875; PMCID: PMC4353552.