PMC3633402_01
Yolk sac tumor with attached sacral bone measuring 6 cm (length) x 4.5 cm (width) x 4.3 cm (depth).
eplasty13e20_fig1.jpg
PMC3633402_01_eplasty13e20_fig1.jpg
F1
At 22 months of age, the Neurosurgery and Orthopedic Surgery Oncology teams performed low sacral amputation and en bloc resection of the tumor through a posterior approach (Fig 1).
Intraoperative photographs. Patient is positioned prone with head oriented to the right. Hash marks on right buttock indicate area that was de-epithelialized and inset into wound (left). Tumor resection resulted in a complex defect with extensive dead space and projection of the rectum into the wound (right).
eplasty13e20_fig2.jpg
PMC3633402_01_eplasty13e20_fig2.jpg
F2
The resultant defect was complex: extensive dead space was formed by bony resection, gluteal and other muscles were lateralized by mass effect, multiple exposed nerve roots filled the field, the rectum projected into the wound causing concern for hernia or pseudohernia, and overlying subcutaneous and skin was inadequate (Fig 2).