PMC8311836_01
a-b) On December, 2015, radiographs showed multiple destructive lesions in the legs; c) on March, 2016, resection of the left bottom part of femur and arthroplasty with megaprosthesis; d) resected tumor - distal part of femur. Chondrosarcoma G3
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fig1
In March 2016, tumor intraarticular resection and left knee replacement surgery were performed (Fig.1), partial resection of patella was performed due to observed changes, followed by adjuvant chemotherapy VIP (etoposide, ifosfamide, and cisplatin) according to the VIP protocol, and the treatment tactic was selected according to the ESMO Clinical Practice Guidelines for diagnosis, treatment, and follow-up.
a) Chondrosarcoma G3, local reoccurrence in patella after 1year (MRI); b-c) 2017, we performed resection and transplantation of patella from a donor (operating room view); d) resected tumor - patella. Chondrosarcoma G3.
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fig2
Due to observed changes patella resection was performed, followed by a reconstruction with donor patella and transplantation (Fig. 2).
a) December 2018, local reoccurrence in proximal tibiae. Curettage of the tumor was performed; b) 2020, amputation in the middle third of the thigh; c) 2020, exarticulation through the hip joint.
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fig3
In 2020 amputation in the middle third of the thigh was performed because of possible pathological fracture, later 1 exarticulation through the hip joint was completed (Fig. 3).
PMC8311836_02
a) Multiple enchondromas in the left hand, about 15 enchondroma foci in all phalanges in fingers I-IV and in metacarpal bones I-IV; b) multiple enchondromas in the foot, about 10 enchondroma foci in toes I-V and metatarsals; c) enchondroma in the proximal part of left tibia.
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fig4
Performed studies showed these changes (Fig. 4): multiple enchondromas in the left hand, about 15 enchondroma foci in all phalanges in fingers I-IV and in metacarpal bones I-IV, about 10 enchondroma foci in toes I-V and metatarsals in the left foot, enchondroma in the proximal part of left tibia.
a) 2020, after amputation of the distal phalanx of IV finger was performed, 13 left hand enchondroma curettages were performed, most of which were performed with cancellous bone grafting; b) 2020, after II toe amputation and 3 curettages with cancellous bone grafting; c) 2020, resection of the tumor recurrence and arthroplasty with a special prosthesis.
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fig5
In 2 years (2018-2019), the patient was hospitalized 7 times, during which a total of 21 surgeries in different locations of bone were performed to protect from pathological fractures (Fig. 5). In February 2019, he underwent surgery for a reoccurrence in the proximal part of the left tibia - curettage with cancellous bone grafting and cementoplasties.