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The Journal of Bone and Joint Surgery 81:848-55 (1999)
© 1999 The Journal of Bone and Joint Surgery, Inc.

Long-Term Survival Following Total Sacrectomy with Reconstruction for the Treatment of Primary Osteosarcoma of the Sacrum. A Case Report*

DAVID A. SPIEGEL, M.D.{dagger}, WILLIAM J. RICHARDSON, M.D.{dagger}, SEAN P. SCULLY, M.D., PH.D.{dagger} and JOHN M. HARRELSON, M.D.{dagger}, DURHAM, NORTH CAROLINA

Investigation performed at Duke University Medical Center, Durham


   Introduction
 
Osteosarcoma of the sacrum occurs in both primary and secondary forms, with the latter including those that develop following radiation therapy and those associated with Paget disease of bone. Osteosarcomas originating in the sacrum are very rare, and most cases in the literature have been grouped with osteosarcomas arising in the vertebral column9-11,13,25,26,32,34,37,40,43,45,50,52. Mortality has been high, which is to be expected in association with any so-called high-grade lesion, as these lesions have a high risk of metastasis and occur in a location that makes adherence to standard oncological principles difficult. Sacral tumors usually have reached an advanced stage and a large size by the time that they are diagnosed, and these conditions make the resection of the tumor technically demanding and the chance of achieving a wide margin less likely. The achievement of an adequate margin often leads to pelvic instability as well as to a loss of . . . [Full Text of this Article]


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