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Efficacy of frozen autograft treated with liquid nitrogen in limb-sparing surgery in feline scapular osteosarcoma: A case report.

ABSTRACT: In recent years, a novel technique of limb preservation has been used in human medicine that involves frozen autograft treated with liquid nitrogen. In this case, frozen autograft treatment along with shoulder joint reconstruction was performed in an 11-year-old cat with osteosarcoma of the distal scapula. Surgical site infection, shoulder dislocation, local recurrence, and pulmonary metastases were not reported for 24 months after surgery. Moreover, the patient was able to bear weight on the operated limb after 2 months of surgery, and excellent limb function without lameness was demonstrated after 15 months. The frozen autograft technique is advantageous because it is inexpensive, simple, and retains its initial strength after treatment, and could be a novel treatment in feline osteosarcoma.

SUBMITTER: Akasaka M

PROVIDER: S-EPMC6715924 | biostudies-literature | 2019 Aug

REPOSITORIES: biostudies-literature

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Efficacy of frozen autograft treated with liquid nitrogen in limb-sparing surgery in feline scapular osteosarcoma: A case report.

Akasaka Minori M Honnami Muneki M Mochizuki Manabu M

The Journal of veterinary medical science 20190708 8

In recent years, a novel technique of limb preservation has been used in human medicine that involves frozen autograft treated with liquid nitrogen. In this case, frozen autograft treatment along with shoulder joint reconstruction was performed in an 11-year-old cat with osteosarcoma of the distal scapula. Surgical site infection, shoulder dislocation, local recurrence, and pulmonary metastases were not reported for 24 months after surgery. Moreover, the patient was able to bear weight on the op ...[more]

PMID: 31281139

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Project description:Introduction and importance Palliative surgery with rigorously selected patients in treating metastatic bone tumour has become more popular recently. This article presents the use of autograft treated by liquid nitrogen in combination with hip prosthesis to reconstruct pathologically subtrochanteric fracture. Case presentation A 54-year-old male suffered left subtrochanteric fracture due to metastatic lesion from his lung cancer. He underwent one-stage surgery for hip tumour resection and reconstruction using the composite of tumour-bearing LNTA and hip prosthesis. He was able to sit in upright position on POD 1 and then to walk without support one month after the operation. His EORTC QLQ-C30 and EORTC QLQ-BM22 scores have significantly improved from 71 and 63 on POD 3 to 53 and 36 at one month after surgery, respectively. Clinical discussion Limb salvage surgery for pathological proximal hip fracture due to metastasis is always challenging. The goal of treatment must include pain-free affected limb with enough function to improve the QoL during the patient's end stage. Several reports on using frozen recycled autograft showed good results regarding anatomical matching, bone healing, function, and cost-effectiveness. We combined prosthesis and LNTA to manage the patient with end stage lung cancer and pathological proximal hip fracture. The patient was satisfied with the 6-month postoperative results before being deceased due to the widespread metastases. Conclusion Composite of LNTA and prosthesis might be a good alternative for treating metastatic fracture due to its anatomical matching, preservation of bone stock and cost-effectiveness where allograft and megaprosthesis are not available. Highlights • Palliative surgery in treating pathologic fracture could improve patient's QoL.• Liquid nitrogen is a reliable method for recycling autogenous bone graft.• Recycled autograft is an alternative option for treating bone defect.• Construct's stability is mandatory to regain QoL in patient with pathologic fracture.

Project description:IntroductionSolitary fibrous tumors (SFTs) of the prostate are extremely rare. We report on a 60-year-old man who was diagnosed with prostatic SFT through transurethral resection (TUR) of the prostate, and we provide a narrative literature review to put the case into perspective. We looked into multiple databases for articles published before June 2022.Case reportA 60-year-old man without comorbidities presented with acute urinary retention and significant macrohematuria. Due to recurrent bladder tamponades and relevant blood loss despite irrigation, an emergency endoscopic transurethral evaluation was initiated. Intraoperatively, diffuse venous hemorrhage from prostatic vessels around the bladder neck was detected, as well as significant hemorrhage from a grossly enlarged and tumor-suspicious prostate middle lobe. Within the framework of extensive bipolar coagulation, parts of the suspicious middle lobe were removed via TUR. The final histopathology report showed incompletely resected SFT of the prostate. Due to the extremely rare SFT diagnosis, the case was discussed in an interdisciplinary tumor board and further diagnostic workup, including thoracoabdominal computed tomography and magnetic resonance imaging of the pelvis, was performed, which revealed no secondary tumors or signs of metastasis. According to the tumor board recommendation, robot-assisted radical prostatectomy (RARP) with bilateral nerve sparing was performed, supported by intraoperative frozen section. The final histopathology confirmed the SFT that had developed from the transition zone. The SFT was resected with negative frozen section result and negative surgical margins (R0). No intra- and perioperative complications occurred, and in the short-term follow-up, the patient presented in excellent general status with full continence. From 1997 to June 2022, we identified a total of 12 publications reporting on treatment for prostatic SFT (11 case reports and 2 patient series), with none performing bilateral nerve sparing, frozen section, or robot-assisted radical prostatectomy. No common survival endpoints were accessible.ConclusionThis case demonstrates the exceedingly rare case of SFT of the prostate, which has been described in the literature in only 23 men worldwide. Here, we were the first to demonstrate the feasibility of bilateral nerve-sparing RARP supported by frozen section. A systematic review was not possible due to the lack of common endpoints.

Dataset Information

Efficacy of frozen autograft treated with liquid nitrogen in limb-sparing surgery in feline scapular osteosarcoma: A case report.

Publications

Efficacy of frozen autograft treated with liquid nitrogen in limb-sparing surgery in feline scapular osteosarcoma: A case report.

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