Published: 2019-01-25

Operative management of chondrosarcoma in pelvic region: case series

I Gede Eka Wiratnaya, Made Wirabhawa, Komang Septian Sandiwidayat, Aakash .


Chondrosarcoma is the second most frequent malignant bone tumour after osteosarcoma. It most often occurs in the pelvis. Treatment of pelvic chondrosarcoma is a difficult problem for the musculoskeletal oncologist. We report 3 patient with chondrosarcoma in pelvic region that undergoing internal hemipelvectomy. First patient, male 28 y.o. with chondrosarcoma in left iliac wing 11.2cm x 10.8cm x 9.2cm. Second, woman, 47 y.o with chondrosarcoma in right superior and inferior pubic rami 13.7cm x 11.5cm x 14.2cm with soft tissue mass around extended to medial part of proximal thigh. Already done A wide excision of the tumor was performed and we use non-vascularized fibular graft (NVFG) to fill the defect. Last patient, pregnant woman 22 y.o. (16weeks gestational age) with chondrosarcoma in right pubic rami 9.8cm x 11.4cm x 13cm. We already done internal hemipelvectomy without terminating the fetus. The second and third patient confirmed with the histopathology result with chondrosarcoma grade II, and the first patient with chondrosarcoma grade I. After 3month post operatively, all of the patients have no pain, no urinary tract complain. The first patient can ambulatory full weight bearing with no crutches or walker. Second patient ambulatory partial weight bearing with crutches. The last patient ambulatory with wheel chair during the pregnancy. Since chondrosarcomas are unresponsive to chemotherapy or radiotherapy, surgical resection was the only therapeutic solution for these patients. It also reinforce the need of a correct diagnose and collaboration between specialities in the treatment of oncological patients.


Chondrosarcoma, Hemipelvectomy, Non-vascularized fibular graft

Full Text:



Akiyama T, Clark JC, Miki Y, Choong PF. The non-vascularised fibular graft: a simple and successful method of reconstruction of the pelvic ring after internal hemipelvectomy. J Bone Joint Surg. British volume. 2010 Jul;92(7):999-1005.

Taconis WK, Van der Heul RO, Taminiau AM. Synovial chondrosarcoma: report of a case and review of the literature. Skeletal Radiol. 1997 Nov 1;26(11):682-5.

Singh P, Kejariwal U, Chugh A. A rare occurrence of enchondroma in neck of femur in an adult female: a case report. JCDR. 2015 Dec;9(12):RD01.

Choong PF, Sim FH, Pritchard DJ, Rock MG, Chao EY. Megaprostheses after resection of distal femoral tumors: a rotating hinge design in 30 patients followed for 2-7 years. Acta Orthopaedica Scandinavica. 1996 Jan 1;67(4):345-51.

Ning Li, Yao-Kun Chen LX. Giant chondrosarcoma at left ischiopubic arch in an elderly man: a case report. Int J Clin Exp Med. 2016;9(7):13206-8.

Ogura K, Sakuraba M, Miyamoto S, Fujiwara T, Chuman H, Kawai A. Pelvic ring reconstruction with a double-barreled free vascularized fibula graft after resection of malignant pelvic bone tumor. Archives of Ortho Trauma Surg. 2015 May 1;135(5):619-25.

Petsatodis G, Stavridis SI, Karataglis D, Christodoulou A. Surgical treatment of a twice recurrent chondrosarcoma of the pubic symphysis: a case report and review of the literature. Cases J. 2009 Dec;2(1):6769.

Lackman RD, Crawford EA, Hosalkar HS, King JJ, Ogilvie CM. Internal hemipelvectomy for pelvic sarcomas using a T-incision surgical approach. Clinical Orthopaedics and Related Research®. 2009 Oct 1;467(10):2677-84.

Wedemeyer C, Kauther MD. Hemipelvectomy-only a salvage therapy?. Orthopedic Reviews. 2011 Mar 17;3(1).

Pedreira R, Siotos C, Cho BH, Seal SM, Bhat D, Carl HM, et al. Vascularized Bone Grafting for Reconstruction of Oncologic Defects in the Spine: A Systematic Review and Pooled Analysis of the Literature. J Reconstr Microsurg. 2018.