CASE 23: Sacrum-Located Osteosarcoma

• 25-year-old male patient
• The patient presented with complaints of difficulty walking due to numbness and tingling accompanied by back, hip, and leg pain.
• The patient was diagnosed with osteosarcoma based on a needle biopsy, but no metastases were detected in subsequent scans.
• Following neoadjuvant chemotherapy, reconstruction was performed using titanium cage, fibula and lumbopelvic fixation after total sacrectomy including the posterior iliac wing and half of the fifth lumbar vertebra.

Before the surgery: X-ray shows irregularity and ossification in the right sacroiliac region.

Before the surgery: The MRI shows tumor tissue and surrounding edema covering the right iliac wing, the upper part of the posterior sacroiliac region, and almost the entire sacrum.

Before the surgery: The MRI shows tumor tissue and surrounding edema covering the right iliac wing, the upper part of the posterior sacroiliac region, and almost the entire sacrum.

Before the surgery: The CT scan shows tumor tissue in the right sacroiliac region accompanied by irregularity and sclerosis.

Before the surgery: The CT scan shows tumor tissue in the right sacroiliac region accompanied by irregularity and sclerosis.

During Surgery: Clinical and fluoroscopic images of the resected tissue.

During and After Surgery: Clinical and radiographic images of fibula reconstruction after total sacrectomy using titanium cages and lumbopelvic fixation.