Osteosarcoma of navicular bone. En bloc excision and salvage of the foot.

Foot Ankle Surg. 2012 Sep;18(3):e29-33. Epub 2012 Apr 16.
Sakellariou VI, Mavrogenis AF, Mazis GA, Papagelopoulos PJ.

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To present foot salvage for osteosarcoma of the navicular bone with en bloc resection and reconstruction using bone allograft and talus-cuneiform arthrodesis. A 20year-old male with a history of osteosarcoma of the distal femur presented to our department 5years later with a metastatic lesion of the navicular bone of the contralateral foot. The patient received 4 cycles of neo-adjuvant chemotherapy with satisfactory response. Tumor shrinkage allowed en bloc excision of the navicular bone with clear margins. Reconstruction was done using a tricortical allograft and talus-allograft-cuneiform arthrodesis, secured with a mini-fracture plate (Synthes). Weight bearing protection was advised for 2months and partial weight bearing for another 4months. Patient received 4 cycles of adjuvant chemotherapy. Three years postoperatively, the patient was free of local recurrence or distant metastasis. There were no signs of allograft resorption, fracture or non union. The patient was asymptomatic and full weight bearing. Ankle and subtalar joint motion was within normal limits. Foot salvage after excision of osteosarcoma of the navicular bone could be possible if en bloc resection of the lesion could be performed. Talus-cuneiform fusion with allograft interposition is a viable reconstructive option.