Bone and soft tissue sarcomas, tumors of the skinBone and soft tissue sarcomas, tumors of the skinСаркомы костей, мягких тканей и опухоли кожи2219-46142782-3687Publishing House ABV Press73710.17650/2219-4614-2025-17-1-91-98REAL CLINICAL CASESКЛИНИЧЕСКИЕ СЛУЧАИThe first experience of total sacral endoprothesis with an individual implant after total sacrectomy (a rare clinical case)Первый опыт тотального эндопротезирования крестца индивидуальным имплантатом после тотальной сакрэктомии (редкий клинический случай)https://orcid.org/0000-0001-9557-3685SofronovD. I.СофроновД. И.
Russian Federation

Denis Igorevich Sofronov

24 Kashirskoe Shosse, Moscow 115522

Денис Игоревич Софронов

115522 Москва, Каширское шоссе, 24

mdsofronov@mail.ruhttps://orcid.org/0009-0003-6356-9130MagomedovaK. N.МагомедоваК. Н.
Russian Federation

2/1 Barrikadnaya St., 123995 Moscow

123995 Москва, ул. Баррикадная, 2/1

https://orcid.org/0000-0003-3635-4380EfimenkoO.ЕфименкоО.
Russian Federation

6 Novatorov St., Moscow 117393

117393 Москва, ул. Новаторов, 6

https://orcid.org/0000-0002-3512-0390BorzovK. A.БорзовК. А.
Russian Federation

24 Kashirskoe Shosse, Moscow 115522

115522 Москва, Каширское шоссе, 24

https://orcid.org/0000-0002-4516-3255FedorovaA. V.ФедороваА. В.
Russian Federation

24 Kashirskoe Shosse, Moscow 115522; 5 Revolyucionnaya St., Yaroslavl 150000

115522 Москва, Каширское шоссе, 24; 150000 Ярославль, ул. Революционная, 5

https://orcid.org/0000-0001-9482-2504KabardaevR. M.КабардаевР. М.
Russian Federation

24 Kashirskoe Shosse, Moscow 115522

115522 Москва, Каширское шоссе, 24

https://orcid.org/0000-0002-9019-8369GalustovA. M.ГалустовА. М.
Russian Federation

24 Kashirskoe Shosse, Moscow 115522

115522 Москва, Каширское шоссе, 24

ShinA. R.ШинА. Р.
Russian Federation

24 Kashirskoe Shosse, Moscow 115522

115522 Москва, Каширское шоссе, 24

SytovA. V.СытовА. В.
Russian Federation

24 Kashirskoe Shosse, Moscow 115522

115522 Москва, Каширское шоссе, 24

https://orcid.org/0000-0002-2038-3729ValievA. K.ВалиевА. К.
Russian Federation

24 Kashirskoe Shosse, Moscow 115522

115522 Москва, Каширское шоссе, 24

N.N. Blokhin National Medical Research Center of Oncology, Ministry of Health of RussiaФГБУ «Национальный медицинский исследовательский центр онкологии им. Н.Н. Блохина» Минздрава РоссииRussian Medical Academy of Continuing Professional Education, Ministry of Health of RussiaФГБОУ ДПО «Российская медицинская академия непрерывного профессионального образования» Минздрава РоссииLLS “TIOS”ООО «ТИОС»Yaroslavl State Medical University, Ministry of Health of RussiaФГБОУ ВО «Ярославский государственный медицинский университет» Минздрава России1704202517191981604202516042025Copyright ©; 2025, Sofronov D.I., Magomedova K.N., Efimenko O., Borzov K.A., Fedorova A.V., Kabardaev R.M., Galustov A.M., Shin A.R., Sytov A.V., Valiev A.K.Copyright ©; 2025, Софронов Д.И., Магомедова К.Н., Ефименко О., Борзов К.А., Федорова А.В., Кабардаев Р.М., Галустов А.М., Шин А.Р., Сытов А.В., Валиев А.К.2025Sofronov D.I., Magomedova K.N., Efimenko O., Borzov K.A., Fedorova A.V., Kabardaev R.M., Galustov A.M., Shin A.R., Sytov A.V., Valiev A.K.Софронов Д.И., Магомедова К.Н., Ефименко О., Борзов К.А., Федорова А.В., Кабардаев Р.М., Галустов А.М., Шин А.Р., Сытов А.В., Валиев А.К.https://creativecommons.org/licenses/by/4.0https://sarbon.abvpress.ru/jour/article/view/737

Bone sarcomas are one the rarest types of malignant tumors comprising only 0.2–1 % of oncological diseases. Chondrosarcoma is the 3rd most common bone sarcoma. This tumor is characterized by low sensitivity to drug and radiological treatment. According to literature data, the current golden standard of bone chondrosarcoma treatment is en bloc radical surgical resection with preservation of clean resection margins. However, common for this tumor location in the pelvic bones can pose difficulties at the stage of surgical planning.

The article presents a clinical case of surgical treatment of sacrum G2 chondrosarcoma in the volume of total sacrectomy with defect replacement using a personalized implant manufactured using a 3D printer and with lumbosacral stabilization.

Саркомы костей являются одним из наиболее редких видов злокачественных новообразований и составляют всего 0,2–1 % онкологических заболеваний. Среди всех сарком костей хондросаркома стоит на 3-м месте по частоте встречаемости. Характерной особенностью данной опухоли является низкая чувствительность к лекарственным и лучевым методам лечения. По данным мировой литературы, в настоящее время «золотым стандартом» лечения хондросарком костей является радикальное хирургическое удаление новообразования единым блоком с сохранением чистых краев резекции. Однако характерная для данной опухоли локализация в костях таза может вызвать определенные трудности на этапе хирургического планирования.

В статье представлен клинический случай хирургического лечения хондросаркомы крестца G2 в объеме тотальной сакрэктомии с замещением дефекта индивидуальным имплантатом, изготовленным с помощью 3D-принтера, и пояснично-тазовой стабилизацией.

chondrosarcomaindividual endoprosthesis3D printingsacral tumorsurgical treatmenttotal sacrectomyхондросаркомаиндивидуальное эндопротезирование3D-печатьопухоль крестцахирургическое лечениетотальная сакрэктомияState budget financing.Государственное бюджетное финансирование.1. Zileli M., Hoscoskun C., Brastianos P., Sabah D. Surgical treatment of primary sacral tumors: complications associated with sacrectomy. Neurosurg Focus 2003;15(5):E9.Zileli M., Hoscoskun C., Brastianos P., Sabah D. Surgical treatment of primary sacral tumors: complications associated with sacrectomy. Neurosurg Focus 2003;15(5):E9.2. Stuckey R.M., Marco R.A. Marco Chondrosarcoma of the mobile spine and sacrum. Sarcoma 2011;2011:274281. DOI: 10.1155/2011/274281Stuckey R.M., Marco R.A. Marco Chondrosarcoma of the mobile spine and sacrum. Sarcoma 2011;2011:274281. DOI: 10.1155/2011/2742813. Boriani S., De Lure F., Bandiera S. et al. Chondrosarcoma of the mobile spine: report on 22 cases. Spine 2000;25(7):804–12. DOI: 10.1097/00007632-200004010-00008Boriani S., De Lure F., Bandiera S. et al. Chondrosarcoma of the mobile spine: report on 22 cases. Spine 2000;25(7):804–12. DOI: 10.1097/00007632-200004010-000084. Shives T.C., McLeod R.A., Unni K.K., Schray M.F. Chondrosarcoma of the spine. J Bone Joint Surg Am 1989;71(8):1158–65.Shives T.C., McLeod R.A., Unni K.K., Schray M.F. Chondrosarcoma of the spine. J Bone Joint Surg Am 1989;71(8):1158–65.5. Gitelis S., Bertoni F., Picci P., Campanacci M. Chondrosarcoma of bone. The experience at the Istituto Ortopedico Rizzoli. J Bone Joint Surg Am 1981;63(8):1248–57.Gitelis S., Bertoni F., Picci P., Campanacci M. Chondrosarcoma of bone. The experience at the Istituto Ortopedico Rizzoli. J Bone Joint Surg Am 1981;63(8):1248–57.6. Arshi A., Sharim J., Park D.Y. et al. Chondrosarcoma of the osseous spine. An analysis of epidemiology, patient outcomes, and prognostic factors using the SEER registry from 1973 to 2012. Spine (Phila Pa 1976) 2017;42:644–52. DOI: 10.1097/BRS.0000000000001870Arshi A., Sharim J., Park D.Y. et al. Chondrosarcoma of the osseous spine. An analysis of epidemiology, patient outcomes, and prognostic factors using the SEER registry from 1973 to 2012. Spine (Phila Pa 1976) 2017;42:644–52. DOI: 10.1097/BRS.00000000000018707. Varga P.P., Bors I., Lazary A. Sacral tumors and management. Orthop Clin North Am 2009;40:105–23. DOI: 10.1016/j.ocl.2008.09.010Varga P.P., Bors I., Lazary A. Sacral tumors and management. Orthop Clin North Am 2009;40:105–23. DOI: 10.1016/j.ocl.2008.09.0108. Zang J., Guo W., Yang R. et al. Is total en bloc sacrectomy using a posterior-only approach feasible and safe for patients with malignant sacral tumors? J Neurosurg Spine 2015;22(6):563–70. DOI: 10.3171/2015.1.SPINE14237Zang J., Guo W., Yang R. et al. Is total en bloc sacrectomy using a posterior-only approach feasible and safe for patients with malignant sacral tumors? J Neurosurg Spine 2015;22(6):563–70. DOI: 10.3171/2015.1.SPINE142379. Nishizawa K., Mori K., Saruhashi Y. Long-term clinical outcome of sacral chondrosarcoma treated by total en bloc sacrectomy and reconstruction of lumbosacral and pelvic ring using intraoperative extracorporeal irradiated autologous tumor-bearing sacrum: a case report with 10 years follow-up. Spine J 2014;14(5):e1–8. DOI: 10.1016/j.spinee.2013.10.057Nishizawa K., Mori K., Saruhashi Y. Long-term clinical outcome of sacral chondrosarcoma treated by total en bloc sacrectomy and reconstruction of lumbosacral and pelvic ring using intraoperative extracorporeal irradiated autologous tumor-bearing sacrum: a case report with 10 years follow-up. Spine J 2014;14(5):e1–8. DOI: 10.1016/j.spinee.2013.10.05710. Newman C.B., Keshavarzi S., Aryan H.E. En bloc sacrectomy and reconstruction: technique modification for pelvic fixation. Surg Neurol 2009:72(6):752–6. DOI: 10.1016/j.surneu.2009.02.008Newman C.B., Keshavarzi S., Aryan H.E. En bloc sacrectomy and reconstruction: technique modification for pelvic fixation. Surg Neurol 2009:72(6):752–6. DOI: 10.1016/j.surneu.2009.02.00811. Fourney D.R., Rhines L.D., Hentschel S.J. et al. En bloc resection of primary sacral tumors: classification of surgical approaches and out-come. J Neurosurg Spine 2005;3(2):111–22. DOI: 10.3171/spi.2005.3.2.0111Fourney D.R., Rhines L.D., Hentschel S.J. et al. En bloc resection of primary sacral tumors: classification of surgical approaches and out-come. J Neurosurg Spine 2005;3(2):111–22. DOI: 10.3171/spi.2005.3.2.011112. Gokaslan Z.L., Romsdahl M.M., Kroll S.S. et al. Total sacrectomy and Galveston L-rod reconstruction for malignant neoplasms. Technical note. J Neurosurg 1997;87(5):781–7. DOI: 10.3171/jns.1997.87.5.0781Gokaslan Z.L., Romsdahl M.M., Kroll S.S. et al. Total sacrectomy and Galveston L-rod reconstruction for malignant neoplasms. Technical note. J Neurosurg 1997;87(5):781–7. DOI: 10.3171/jns.1997.87.5.078113. Nassif N.A., Buchowski J.M., Osterman K., McDonald D.J. Surgical technique: iliosacral reconstruction with minimal spinal instrumentation. Clin Orthop Relat Res 2913;471(3):947–55. DOI: 10.1007/s11999-012-2643-6Nassif N.A., Buchowski J.M., Osterman K., McDonald D.J. Surgical technique: iliosacral reconstruction with minimal spinal instrumentation. Clin Orthop Relat Res 2913;471(3):947–55. DOI: 10.1007/s11999-012-2643-614. Ogura K., Sakuraba M., Miyamoto S. et al. Pelvic ring reconstruction with a double-barreled free vascularized fibula graft after resection of malignant pelvic bone tumor. Arch Orthop Trauma Surg 2015;135(5):619–25. DOI: 10.1007/s00402-015-2197-7Ogura K., Sakuraba M., Miyamoto S. et al. Pelvic ring reconstruction with a double-barreled free vascularized fibula graft after resection of malignant pelvic bone tumor. Arch Orthop Trauma Surg 2015;135(5):619–25. DOI: 10.1007/s00402-015-2197-715. Lin P., Shao Y., Lu H. et al. Pelvic reconstruction with different rod-screw systems following Enneking type I/I + IV resection: a clinical study. Oncotarget 2017;8(24):38978–89. DOI: 10.18632/oncotarget.17164Lin P., Shao Y., Lu H. et al. Pelvic reconstruction with different rod-screw systems following Enneking type I/I + IV resection: a clinical study. Oncotarget 2017;8(24):38978–89. DOI: 10.18632/oncotarget.1716416. Sabourin M., Biau D., Babinet A. et al. Surgical management of pelvic primary bone tumors involving the sacroiliac joint. Orthop Traumatol Surg Res 2009;95(4):–92. DOI: 10.1016/j.otsr.2009.04.008Sabourin M., Biau D., Babinet A. et al. Surgical management of pelvic primary bone tumors involving the sacroiliac joint. Orthop Traumatol Surg Res 2009;95(4):–92. DOI: 10.1016/j.otsr.2009.04.00817. Liang H., Li D., Guo W. et al. Lateral lumbar vertebral body screw predisposes to neuralgia after limb-salvage surgery for pelvic tumors: a single-center, retrospective study of 349 cases. Eur Spine J 2016;25(12):4094–102. DOI: 10.1007/s00586-016-4685-zLiang H., Li D., Guo W. et al. Lateral lumbar vertebral body screw predisposes to neuralgia after limb-salvage surgery for pelvic tumors: a single-center, retrospective study of 349 cases. Eur Spine J 2016;25(12):4094–102. DOI: 10.1007/s00586-016-4685-z18. Hu X., Lu M., Wang Y. et al. Advanced pelvic girdle reconstruction with three dimensional-printed custom hemipelvic endoprostheses following pelvic tumour resection.Int Orthop 2024;48(8):2217–31. DOI: 10.1007/s00264-024-06207-3Hu X., Lu M., Wang Y. et al. Advanced pelvic girdle reconstruction with three dimensional-printed custom hemipelvic endoprostheses following pelvic tumour resection.Int Orthop 2024;48(8):2217–31. DOI: 10.1007/s00264-024-06207-319. Kotrych D., Angelini A., Bohatyrewicz A., Ruggieri P. 3D printing for patient-specific implants in musculoskeletal oncology. EFORT Open Rev 2023;8(5):331–9. DOI: 10.1530/EOR-23-0066Kotrych D., Angelini A., Bohatyrewicz A., Ruggieri P. 3D printing for patient-specific implants in musculoskeletal oncology. EFORT Open Rev 2023;8(5):331–9. DOI: 10.1530/EOR-23-0066