Reclaiming the Limbs

Successful treatment of Grade 2 Osteosarcoma in
a young boy

THE CASE

THE CASE A 18-year old boy diagnosed with Osteosarcoma of right lower femur was referred from Kolkata to Nanavati Super Speciality Hospital in Mumbai for medical management and further treatment.

THE PROCEDURE

Upon admission in Nanavati Hospital, a needle biopsy was done which revealed intermediate Grade 2 Osteosarcoma. He was given 3 cycles of Chemotherapy before surgery. This comprised of medication for 3 days followed by a 21 day medicine free period. After Chemotherapy is instituted, a waiting period of 21 days was maintained for the WBC count to return to normal, which drops during Chemotherapy. After the waiting period got over, the second cycle of Chemotherapy was administered. During this time, the patient was counselled for surgery, the risk involved and the financial implications.

After 3 cycles of Chemotherapy, which was around 60-65 days, the surgeon removed the tumour with safe margins all around it (en bloc resection) following the oncology principles. Once the defects were reconstructed, the soft tissue closures were shaped and the patient was sent back for physiotherapy. The tumour that is resected was assessed for the completeness of resection and also the onset of necrosis resulting from Chemotherapy.

THE RESULT

After the surgery and physiotherapy session, the patient experienced almost full range of flexion. He is now able to return to his full functional capacity and has the ability to squat on floor even after a major length resection (19 cms). The patient is comfortable, sits on the floor, and has resumed all his normal activities.

DISCUSSION

Carcinoma of limbs which was treated very dismally in the past is being treated very well now. Patients have moved on from the place of seclusion to a life full of function. They are socially active, have resumed their jobs and live a normal life. With regular follow-up and Chemotherapy sessions, almost 70% patients when diagnosed early with Osteosarcoma have high (10-year disease free) survival rate. With Chemotherapy advancements, outcomes have improved in the last 15-20 years.


Dr. Abdul Samad Ansari

Dr. Haresh Manglani
Sr. Consultant
Ortho − Oncologist
Nanavati Super Speciality
Hospital, Mumbai


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