Ba2cf4148007ed8a8b041f8abd9bbf96 3

Tibial Osteosarcoma - Partial Prosthesis and Ligamentoplasty

Partial Tibia Prosthesis. Female patient, 12 years old, date of birth March 18, 2003, started in April with pain and lameness, consulted in several centers and was treated with analgesics.

She was admitted to the hospital in May and underwent a punch biopsy. The anatomopathological report indicated a localized conventional central osteosarcoma, with negative cultures. She was staged with chest CT, total body bone scintigraphy and MRI of the right lower limb. She underwent three cycles of neoadjuvant chemotherapy with Platinum and Doxorubicin, with a good response.

Figura 1: RM axial T1 tse.
Figure 1: Axial T1 tse MRI.
Figura 3: Rm axial T1 tse.
Figure 2: Axial Rm T1 tse. Figure 3: Axial Rm T1 tse.
Figura 5: RM axial T1 tse.
Figure 4: Axial T1 tse MRI. Figure 5: Axial T1 tse MRI.
Figura 6: RM axial T2 tse-fil.
Figure 6: Axial T2 tse-fil MRI.
Figura 8: Rm axial T2 tse-fil.
Figure 7: Axial T2 tse-fil MRI. Figure 8: Axial T2 tse-fil MRI.
Figura 10: RM axial T2 tse-fil.
Figure 9: Axial T2 tse-fil MRI. Figure 10: Axial T2 tse-fil MRI.
Figura 11: RM axial T1 tse-gad.
Figure 11: Axial T1 tse-gad MRI.
Figura 13: RM axial T1 tse-gad.
Figure 12: Axial T1 tse-gad MRI. Figure 13: Axial T1 tse-gad MRI.
Figura 15: RM axial T1 tse-gad.
Figure 14: Axial T1 tse-gad MRI. Figure 15: Axial T1 tse-gad MRI.
Figura 16: RM cor T1.
Figure 16: T1 color MRI.
Figura 17: RM cor Stir.
Figure 17: MRI Color Stir.
Figura 18: RM cor stir-fil.
Figure 18: Stir-fil color MRI.
Figura 19: RM sag-stir-fil.
Figure 19: RM sag-stir-fil.
Figura 20: RM axial T1 tse-fil.
Figure 20: Axial T1 tse-fil MRI.
Figura 22: RM axial T1 tse-fil.
Figure 21: Axial T1 tse-fil MRI. Figure 22: Axial T1 tse-fil MRI.
Figura 24: RM axial T1 tse-fil.
Figure 23: Axial T1 tse-fil MRI. Figure 24: Axial T1 tse-fil MRI.
Figura 25: RM axial T1 tse-fil-gad.
Figure 25: Axial T1 tse-fil-gad MRI.
Figura 27: RM axial T1 tse-fil-gad.
Figure 26: T1 tse-fil gad axial MRI. Figure 27: Axial T1 tse-fil-gad MRI.
Figura 29: RM axial T1 tse-fil-gad.
Figure 28: Axial T1 tse-fil-gad MRI. Figure 29: Axial T1 tse-fil-gad MRI.
Figura 30: RM axial T2 tse-fil
Figure 30: Axial T2 tse-fil MRI
Figura 32: RM axial T2 tse-fil.
Figure 31: Axial T2 TSE-FIL MRI. Figure 32: Axial T2 tse-fil MRI.
a Figura 34: RM axial T2 tse-fil.
Figure 33: Axial T2 tse-fil MRI. Figure 34: Axial T2 tse-fil MRI.
Figura 35: RM cor T1.
Figure 35: T1 color MRI.
Figura 36: RM cor-stir
Figure 36: RM cor-stir
Figura 37: RM cor-T1-gad.
Figure 37: Cor-T1-gad MRI.
Figura 38: RM sag-stir
Figure 38: RM sag-stir
Figure 39: Photo of the hospital
Figure 40: Surgical team.
Figura 41: Radiografia de frente da tíbia esquerda.
Figure 41: Radiograph of the front of the left tibia.
Figura 42: Radiografia de perfil da tíbia esquerda, evidenciando a lesão na região proximal.
Figure 42: Profile x-ray of the left tibia, showing the lesion in the proximal region.
Figura 43: Paciente na posição monopodal.
Figure 43: Patient in the single-leg position.
Figura 44
Figure 44
Figura 45: Paciente em decúbito dorsal sobre a mesa cirúrgica.
Figure 45: Patient in supine position on the surgical table.
Figura 46: Paciente em decúbito dorsal com o membro esquerdo sobre a mesa.
Figure 46: Patient in supine position with the left limb on the table.
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VIdeo:  017

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VIdeo: 024
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Figure 85: Photo of the team - end of surgery.
Figura 86: Paciente após uma semana da cirurgia, em 20/08/2015.
Figure 86: Patient one week after surgery, on 08/20/2015.
Figura 87: Boa cicatrização após uma semana da cirurgia.
Figure 87: Good healing one week after surgery.
Figura 88: O sorrizo denota a tranquilidade da paciente, sem dor, após uma semana da cirurgia, em 20/08/2015.
Figure 88: The smile denotes the patient's tranquility, without pain, one week after surgery, on 08/20/2015.
Figura 89: Radiografia, frente, após dez dias, em 22/08/2015.
Figure 89: Radiograph, front, after ten days, on 08/22/2015.
Figura 90: Radiografia em perfil.
Figure 90: Profile x-ray.
Figura 91: Paciente no dia da alta hospitalar, dez dias após a cirurgia, em 20/08/2015.
Figure 91: Patient on the day of hospital discharge, ten days after surgery, on 08/20/2015.

Author: Prof. Dr. Pedro Péricles Ribeiro Baptista

 Orthopedic Oncosurgery at the Dr. Arnaldo Vieira de Carvalho Cancer Institute

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