Osteosíntesis sobre sarcomas inadvertidos: El desafío de tratar fracturas patológicas

Abstract

Osteosarcoma is a primary malignant bone tumor, it manifests itself in patients with intermittent pain and progreses to constant pain and does not remit with analgesia. The differential diagnosis is osteomyelitis and Ewing's sarcoma. The standard treatment scheme includes neoadjuvant chemotherapy followed by surgical resection and again by chemotherapy. About 10% of patients debut with a pathological fracture. In the management of these fractures, the etiological determination of the fracture is of the utmost importance, whether this is due to a primary bone tumor or a metastatic bone tumor, since this will determine the behavior to be followed, as well as the patient's vital prognosis. The diagnosis of a pathological fracture and its proper management poses a challenge for the Orthopedic Surgeon, who, upon suspicion, must perform an adequate anamnesis, an exhaustive physical examination and use other studies such as contrast-enhanced magnetic resonance imaging.