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3D Printed Osteosarcoma of Femur
A 16-year old male presented with a 3-month history of increasingly swollen and painful right knee. On examination, there was a palpable tender swelling above the right knee. Blood test showed a raised Alkaline Phosphatase level. A knee x-ray showed periosteal reactive changes in the distal femur suspicious for a bone malignancy. The patient then underwent staging CT and MRI evaluation of the right leg. He underwent adjuvant chemotherapy prior to resection of his right femur. He made a full recovery.
The specimen is the patient’s excised distal femur. On the cut surface, there is a large pale infiltrating tumour, 10 cm in greatest diameter, extending through the periosteum near the articular surface. This is an osteosarcoma of the femur.
Osteosarcomas are a malignant tumour of bones that are characterised by the production of osteoid matrix or immature bone. It is the most common primary malignancy of bone. Most occur in the distal femur with the tibia and humerus being the most frequent sites affected. Men are more commonly affected than women. They occur in a bimodal age distribution, with most occurring in children and adolescents under 20 years of age and the second peak occurring in older adults over 60.
Secondary osteosarcomas are more common in older patients. Secondary osteosarcomas occur in patient’s bones with predisposing conditions such as Paget‘s disease, bone infarcts and previous irradiation. Mutations in tumour suppressors and oncogenes, such as RB, TP53 and INK4a have been shown in osteosarcomas.
Osteosarcomas usually present with painful, enlarging masses. Pathological fractures can also be the first presenting
complaint. Constitutional symptoms are usually not present. Alkaline phosphatase and lactate dehydrogenase may be
elevated on blood tests. X-rays can show features of bone destruction, a mass or signs of a periosteal reaction,
such as a sunburst appearance or triangular shells of reactive bone (Codman‘s Triangle). MRI of the affected bone is
used to evaluate local staging of the tumour while CT of the body is used to evaluate for distant spread. The tumour
may be biopsied in some cases.
The lungs are the most common site for distant metastases followed by the bones and brain. Treatment involves neoadjuvant chemotherapy followed by surgery. 5-year survival rate for localised osteosarcoma is 60-70% but this drops to <20% in patients with distant metastases.
GTSimulators by Global Technologies
Erler Zimmer Authorized Dealer
The models are very detailed and delicate. With normal production machines you cannot realize such details like shown in these models.
The printer used is a color-plastic printer. This is the most suitable printer for these models.
The plastic material is already the best and most suitable material for these prints. (The other option would be a kind of gypsum, but this is way more fragile. You even cannot get them out of the printer without breaking them).The huge advantage of the prints is that they are very realistic as the data is coming from real human specimen. Nothing is shaped or stylized.
The users have to handle these prints with utmost care. They are not made for touching or bending any thin nerves, arteries, vessels etc. The 3D printed models should sit on a table and just rotated at the table.