Cost-effective Reconstruction Using a 3D-Printed Cement Spacer in a Unique Case of Calcaneal Ewing Sarcoma

Overview

This case study presents a 19-year-old female with Ewing sarcoma of the calcaneus, treated with neoadjuvant chemotherapy followed by limb salvage surgery using a 3D-printed cement spacer. The patient experienced complications post-surgery.

Background

Ewing sarcoma is a significant malignancy among children and young adults, accounting for 15% of primary bone tumors. Calcaneal involvement is rare, making effective treatment strategies critical for improving patient outcomes. Advances in 3D printing technology offer innovative solutions for reconstructive surgery in complex cases, particularly in the context of limb salvage.

Data Highlights

No numerical data available in the source material.

Key Findings

• A 19-year-old female presented with a calcaneal Ewing sarcoma, confirmed by histopathology.
• Neoadjuvant chemotherapy resulted in tumor regression prior to limb salvage surgery.
• Reconstruction utilized a custom-made 3D-printed PMMA cement spacer.
• The patient developed wound dehiscence post-surgery, requiring a free radial forearm flap.
• At 1-year follow-up, the patient ambulated with a cane and a Toronto Extremity Salvage Score of 62.5%.
• By 2.5 years, she developed a deep surgical site infection, which was successfully managed.

Clinical Implications

This case illustrates the use of 3D-printed implants in reconstructive surgery for Ewing sarcoma.

Conclusion

The use of a 3D-printed cement spacer in this case demonstrates a surgical option for limb salvage in calcaneal Ewing sarcoma.

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