CASE 5: Osteosarcoma Located in the Lumbar, Sacrum, and Iliac Wing

• 15-year-old girl patient
• A patient who had been experiencing pain and swelling for 8 months was diagnosed with osteosarcoma after a biopsy abroad. Since no metastases were detected in subsequent scans, the patient underwent 3 rounds of chemotherapy.
• Following L5, sacrum, and iliac crest resection, reconstruction was not performed on the patient due to the existing general condition and risk of infection.
• Following wound healing, the patient was referred to a pediatric oncologist for chemotherapy.

Preoperative: MRI shows a large tumor tissue causing bone damage and extending into soft tissue, involving the entire 5th lumbar vertebra, sacrum, and iliac wing.

Preoperative: MRI shows a large tumor tissue causing bone damage and extending into soft tissue, involving the entire 5th lumbar vertebra, sacrum, and iliac wing.

Preoperative scan: CT scan shows a large tumor tissue causing bone damage and extending into soft tissue, involving the entire 5th lumbar vertebra, sacrum, and iliac wing.

During the operation: Inclusion of the external iliac vein in the resection and bypass with a graft.

Surgical procedure: Exposure of the dura and roots after lumbosacral laminectomy.

During the operation: Clinical appearance of the removed tumor tissue.

During the operation: Fluoroscopy image of the removed tumor tissue.

Post-operative: Seen on X-ray after resection.