Abstract

Abstract: One patient with a histologic diagnosis of reticulum cell sarcoma of the femur has been observed for 12 years. The patient received high voltage irradiation to the entire femoral shaft (4,000 rods). A pathologic fracture occurred through the initial biopsy site. Several efforts at external and internal fixation were made, and homologous and autogenous bone grafts were used in an effort to obtain healing of the fracture and to revascularize the femur. The femur was biopsied on several occasions and showed no recurrence of tumor, but did demonstrate avascular necrosis. Twelve years after original diagnosis, the patient continues to be active with three inches of shortening of the femur. The questions to be answered are: (1) Should the femoral shaft be replaced with a prosthesis? (2) Will this femur undergo malignant degeneration? (3) Once radiation therapy of this magnitude is completed, what is the best course of management?