Hondrosarcoma of the chest with intraabdominal distribution (case report).

A rare clinical observation of chondrosarcoma metastasis into the abdominal cavity with a specific metastatic ascitic fluid is presented. Chondrosarcomas that occur as a result of malignant transformation of benign chondroma are quite rare. Even less often in the literature, cases of chondrosarcoma metastases are described, especially in a peritoneum with the presence of metastatic ascites. The article describes a case of metastatic ascites in a 38-year old patient with chondrosarcoma, which developed against the background of previously resected rib chords. The article describes the cytological signs of chondrosarcoma in ascitic fluid.

[Surgical treatment of patients with chest wall metastases]. / Khirurgicheskoe lechenie patsientov s metastaticheskim porazheniem grudnoi stenki.

OBJECTIVE: To evaluate postoperative outcomes in patients with chest wall metastases. MATERIAL AND METHODS: We analyzed 40 patients who underwent surgery for chest wall metastatic lesions. Fourteen (35%) patients had sternal lesion, 26 (65%) ones - rib metastases. We used implants for chest wall defect closure in 15 (37.5%) patients. Chest wall repair with autologous tissues was performed in 19 (47.5%) patients. RESULTS: Median survival was 17 months. Most patients (n=30, 75%) showed improvement in the quality of life according to Karnofsky and EGOG scale after surgery. Continued tumor growth occurred in 4 (10%) patients within 8-16 months after surgery. There were 2 patients who suffered from tumor recurrence accompanied by other metastatic foci (progression). Complications were diagnosed in 5 (12.5%) patients. Tactical errors were identified in 4 (10%) patients and they were associated with progression of cancer in the form of new metastatic foci within 6 months after surgery. CONCLUSION: Active surgical approach for bone metastases in patients with favorable cancer-related prognosis can improve quality of life and survival at least in case of solitary lesions. New program for treatment strategy selection based on prognosis of life expectancy and algorithms of surgical treatment will reduce the risk of erroneous management and increase its effectiveness.

[Treatment of patients with metastatic lesions of the long bones]. / Lechenie patsientov s metastaticheskim porazheniem dlinnykh kostei.

OBJECTIVE: To optimize orthopedic care in patients with complicated course of metastatic lesions of the long bones. MATERIAL AND METHODS: There were 201 patients (72 men and 129 women) who underwent orthopedic care for metastatic lesions of the long bones for the period from 2006 to 2019. Breast cancer metastases were diagnosed in 71 (35%) cases, kidney cancer - 56 (28%) patients, prostate cancer - 19 (9%) cases, metastases without a primary identified focus - 15 (8%) patients. Other forms were observed in 40 (20%) patients. All patients were divided into two groups. The first group included 136 patients (68%) who underwent segmental resections with bone replacement. Of these, 100 (73%) patients had secondary lesions of the lower limb bones and 36 (27%) patients with metastatic lesions of the upper limb bones. A threat of pathologic fracture was in 63 (46%) cases, fracture - in 73 (54%) patients. The second group consisted of 65 (32%) patients who underwent immersion osteosynthesis. Of these, 47 (72%) patients had metastatic lesions of the lower limb bones and 18 (28%) patients had secondary lesions of the upper limb bones. A threat of pathologic fracture was in 24 (37%) patients, fracture - in 41 (63%) patients. RESULTS: In the first group, mean surgery time was 140 min, in the second group - 120 min. Mean blood loss in the first group was 600 ml, in the second group - 300 ml. Patients were activated on the 3rd postoperative day in both groups. We analyzed surgical, anatomical and functional results in both groups using MSTS, Watkins and Karnofsky's scales. CONCLUSION: Oncological replacement and osteosynthesis are the main methods of surgical treatment of secondary lesions of the long bones. However, our data emphasize advisability of bone replacement, since this method ensures the most adequate stabilization, pain syndrome relief and long-term improvement of the quality of life.

[Surgical treatment of malignant tumors of the thoracic wall].

23 patients with malignant tumors of the thoracic wall, invading bone structures, were operated in the period of 2005-2009 years. Thoracic wall reconstruction was performed in 20 (77%) of patients. The type of the reconstruction was defined by tumor localization, volume of resection, anatomic features of transplantational tissue flaps. Surgical method remains the mainstay in the treatment of the thoracic wall tumors. Although in cases of highly malignant bone or soft tissue sarcomas, only combined and complex methods allow the achievement of satisfactory results.