diaphyseal femur; allograft-fibula
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- Moris Gaines
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1 54 yo 1st referral: Feb 6th, 2013 HPI: - Pain in left thigh for 1 year. Initially very low, on charge. - no night pain, no increased sweating. - no analgesics PMH: - Arterial hypertension
2 54 yo 1st referral: Feb 6th, 2013 clinical findings: - normal gait - exam of hip and knee normal - neurovascular exam normal
3 CT left thigh: Jan 14th, 2013 Cor + contrast
4 Chest-CT: Jan 14th, 2013 No pulmonary nodules
5 MRI: Jan 16th, 2013 STIR T1
6 MRI: Jan 16th, 2013 T1 T1+Gado
7 PET: Jan 25th, 2013
8 PET: Jan 25th, 2013 no other lesions
9 Biopsy: Feb 6th, 2013
10 Result Biopsy: Feb 6th, 2013 Kappa/lambda Proliferationsfraktion (mib1)
11 Sarcoma- Board: February 14, 2013 Therapeutic decisions: The board has agreed to recommend, because of the diagnosis, a bone marrow biopsy. If there is just one lesion to see in PET- CT, the resection of the lesion would be initiated and then start with the chemotherapy.
12 Result Biopsy: Feb 6th, 2013
13 Follow-up PET-CT: Mar 28, 2013 No other lesions
14 Neoadj RT: Apr 4 May Neoadjuvant RT: 50.4Gy From April 4 to May
15 MR thigh left: Jan Jun 2013 Jan 16, 2013 Jun 13, 2013 lat ap lat ap SPAIR STIR T1 fs T1 TIRM
16 Rx thigh left: Jun 13, 2013
17 Surgery: Jun 18, 2013 Jun 13, 2013 Jan 16, 2013
18 Surgery: Jun 18, ) Vastus lateralis 2) Vastus intermedius 3) Vastus medialis 4) Rectus femoris 5) Biceps femoris - a) Caput longum - b) Caput brevis 6) Sartorius 7) Gracilis 8) Semitendinosus 9) Semimenbranosus 10) Adductor longus/ magnus a 5b a) Septum interm. Femoris med b) Septum interm. Femoris lat a 2 b 1
19 Surgery: Jun 18, 2013 hip knee lateral
20 Surgery: Jun 18, 2013 Vastus lateralis knee hip Septum intermusculare femoris lateralis Femur
21 Surgery: Jun 18, 2013 NCB-locking plate knee hip
22 Surgery: Jun 18, 2013 Drill wholes proximal and distal to determinate lenght and rotation knee hip
23 Surgery: Jun 18, 2013 Remove the plate knee hip
24 Surgery: Jun 18, 2013 Remove the tumor Tumor
25 Surgery: Jun 18, 2013 Tumor Allograft with cement Allograft cement
26 Surgery: Jun 18, 2013 Allograft with cement Allograft cement
27 Surgery: Jun 18, 2013 Fixation the NCB-locking plate
28 Surgery: Jun 18, 2013 Fixation the NCB-locking plate
29 Surgery: Jun 18, 2013 Fixation the NCB-locking plate
30 Surgery: Jun 18, 2013 Compression bone-allograft with two small plates compression compression
31 Surgery: Jun 18, 2013 Compression bone-allograft with two small plates compression compression
32 Surgery: Jun 18, 2013 Compression bone-allograft with two small plates compression compression
33 Surgery: Jun 18, 2013 Definitive fixation NCB-locking plate
34 Surgery: Jun 18, 2013 Definitive fixation NCB-locking plate
35 Surgery: Jun 18, 2013
36 x-ray left femur, June 18, 2013
37 Histopathology, June 18, 2013
38 Histopathology, June 18, 2013
39 Histopathology, June 18, 2013
40 Sarcoma- Board: July 11, 2013 Therapeutic decisions: Radiotherapy: No Chemotherapy: Yes, the tumor is considered as a systemic disease, therefore, adjuvant chemotherapy is Recommended Surgery: tumor resection was held at the Balgrist at 18:06:13.
41 Follow up X-Ray: October, 23th, 2013
42 Follow up MRI thigh: October, 23th, 2013 No local recurrence T1_tirm T1_tse_KM
43 Clinical findings: November, 5th, 2013 HPI: Suddenly pain in the left thigh after change from sitting to up right position. clinical findings: Dolent distal third of the left thigh. Normal sensibility and motoric control.
44 X-Ray: November, 6th, 2013
45 Re-Surgery: November, 7th, 2013 proximal Femur with allograft distal medial Anastomosis A. femoralis V. femoralis Fibula
46 intra-op X-Ray: November, 7th, 2013
47 clinical pic: November 13, 2013
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