General Considerations
•OSA and CSA are the most common pelvic tumors
•pelvis OSA had a similar biologic behaviour to appendicular OSA
•diagnosis: survey radiographs and CT to assess presence and degree of sacral involvement
Treatment
•3 classifications of hemipelvectomy: radical, conservative, and internal
•radical: limb amputation with separation of pelvis through sacroiliac joint
•conservative: limb amputation with preservation of sacroiliac joint and cranial ilium
•internal: preservation of limb
•musculocutaneous flaps are preferred for wound closure although fasciocutaneous flaps acceptable
•medial extent of the tumor is the most difficult dissection with midline (sacrum or pubis) the surgical limit
•complications are rare and similar to limb amputation
•complications in humans include infection, skin flap necrosis, herniation, fecal and urinary incontinence if pudendal nerve roots transected, thromboembolic disease, and local tumor recurrence
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PELVIC TUMORS
T0
No evidence of neoplasia
T1
Tumor confined within the medulla and cortex
Primary Tumor
T2
Tumor extends beyond the periosteum
M0
No evidence of lymph node involvement
M1
Evidence of distant metastasis with site specified
Metastasis