Pelvic Bone Tumors and Pregnancy: Clinical Cases of Successful Pregnancy and Delivery after Radical Surgical Treatment

Abstract

Introduction. Primary malignant neoplasms of the bone and cartilage system account for approximately 1 % of the total number of oncological diseases worldwide. The primary treatment option for this group of patients is surgical removal of the tumor. Radical surgery on the bone structures of the pelvis is certainly associated with a reduction in quality of life. As a result, many designs with a wide range of properties have recently been developed to replace defects in this area. There are very few reports in the literature of successful fertility recovery after treatment of women with pelvic bone malignancies.

Case Description. This article presents our own experience of successful treatment of patients with musculoskeletal tumors involving the pelvic ring and subsequent successful pregnancy and delivery. We present two clinical cases of successful realization of reproductive function in women who have undergone surgical treatment for musculoskeletal tumors. In the first case, the patient was diagnosed with recurrent soft tissue liposarcoma of the upper third right thigh. An interilio-abdominal amputation of the right lower limb followed by exoprosthesis was performed. Chondrosarcoma (G2) of the right pelvic bone was confirmed in the second case. Pathologic acetabular fracture. Surgical treatment included pelvic bone resection with simultaneous pelvic ring reconstruction and hip replacement. A bespoke implant, made using additive manufacturing (AM) with a special medical grade titanium nickelide powder, was used to replace the defect in the bone structures. Both women were successfully delivered by caesarean section at 29 and 35 weeks of gestation, respectively. There is currently no data on relapse. Children grow and develop according to their age.

Conclusion. Today, young women affected by tumor lesions of the pelvic bones and adjacent soft tissues have the option of organ-sparing treatment, which preserves the basic functions and physiology of the pelvic organs. With timely referral to specialists, it is possible to have a baby, start and maintain a full-fledged family.