Key result
Emergency forequarter amputation for high-volume proximal humerus osteosarcoma with vascular compromise improved short-term quality of life, but the patient died from lung metastasis 13 months later.
Why the study?
Osteosarcoma of the proximal humerus is associated with poor outcomes and vascular structures nearby, but the degree of vascular involvement is rarely evaluated and reported.
Case Report (n=1)
No
Osteosarcoma of the proximal humerus can cause severe vascular compromise requiring emergency amputation.
May support palliative emergency amputation in rare vascular emergencies; hypothesis-generating for survival in advanced osteosarcoma.
BACKGROUND Osteosarcoma is the most common type of malignant bone tumor arising from mesenchymal stem cell. When occurring on the proximal humerus, it is associated with poor outcomes; there are numerous neurovascular structures around proximal humerus. Unfortunately, the degree of vascular involvement in osteosarcoma is rarely evaluated and reported. Thus, we would like to highlight our case. CASE REPORT We reported a case of left proximal humerus osteosarcoma causing dead limb in a 14-year-old boy. The dead limb progressed in the span of 3 weeks. An emergency forequarter amputation (FQA) was conducted to prevent further complications such as septicemia and mortality. Two months after the surgery, the patient had improved quality of life. One year after, the patient had no local recurrence. However, there was a lung metastasis detected 9 months after the surgery. The patient died 13 months after the surgery. CONCLUSIONS Osteosarcoma of the proximal humerus can potentially compromise vascular structures. Early diagnosis and treatment are mandatory to prevent such complications.
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Irsan et al. (2020) conducted a case report in Osteosarcoma of left proximal humerus with vascular compromise (n=1). Emergency forequarter amputation was evaluated on Clinical outcome (survival and quality of life). Emergency forequarter amputation for high-volume proximal humerus osteosarcoma with vascular compromise improved short-term quality of life, but the patient died from lung metastasis 13 months later.
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