PMC9343173_01
(A) Anteroposterior pelvis radiograph showing Ewing sarcoma is located at the right ilium closed to the sacroiliac joint and acetabulum (arrow). (B) The T1-weighted axial sequence magnetic resonance image showed a bone tumor at the ilium. A white arrow demonstrated soft-tissue extension in the iliopsoas and gluteus muscle.
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Plain radiographs of the right pelvis revealed a mixed permeative osteolytic and osteoblastic lesion at the ilium and periacetabulum (Figure 1A). Magnetic resonance imaging (MRI) of the pelvis demonstrated bony destruction at the right ilium extending close to the sacroiliac joint and acetabulum with soft-tissue involvement in iliopsoas and gluteus muscles (Figure 1B).
(A) An immediate postoperative anteroposterior pelvis radiographic study following internal hemipelvectomy. (B) At the 9th year follow-up, the pelvic radiographic study demonstrated an upward migration of the femoral head.
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Internal hemipelvectomy with type I resection, according to Enneking and Dunham's classification of pelvic tumor resection, was performed by making osteotomy at the sacroiliac joint and above the acetabulum (Figure 2A). A recent plain radiograph of the pelvis revealed no bone destruction and more inner-upward migration of the head of the femur (Figure 2B).
CT scan of the lower abdomen illustrated right ureteric stricture (arrow).
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There was no bony destruction or soft-tissue mass around the remaining right pelvic bone (Figure 3).
(A) Fluoroscopic radiograph shows the femur's head closed to the ureter while applying the ureteric stent. (B) KUB radiograph shows a good position of the stent inside the right ureter and urinary bladder.
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The fluoroscopic and KUB radiographs revealed upward, and inner migration of the head of the femur close to the ureteric-vesical junction within the deformed right pelvic ring (Figure 4A and B).