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Novel Surgical Reconstruction Using a 3D Printed Cement Mold Following Resection of a Rare Case of Proximal Ulna Osteosarcoma: A Case Report and Description of the Surgical Technique
by
, , , , , and
Abdulrahman Alaseem
1
,
Hisham A. Alsanawi
1,
Waleed Albishi
1,
Ibrahim Alshaygy
1
,
Sara Alhomaidhi
2,*,
Mohammad K. Almashouq
1,
Abdulaziz M. AlSudairi
1,
Yazeed A. Alsehibani
1 and
Abdulaziz O. Almuhanna
1 1
Department of Orthopedic Surgery, College of Medicine, King Saud University, Riyadh 1211, Saudi Arabia
2
College of Medicine, King Saud University, Riyadh 1211, Saudi Arabia
*
Author to whom correspondence should be addressed.
Curr. Oncol. 2025, 32(8), 411; https://doi.org/10.3390/curroncol32080411
Submission received: 3 June 2025
/
Revised: 11 July 2025
/
Accepted: 19 July 2025
/
Published: 22 July 2025
(This article belongs to the Section Bone and Soft Tissue Oncology)
Simple Summary
Osteosarcoma is a serious type of bone cancer that usually affects the knee. When it occurs in less common locations like the ulna (one of the forearm bones), it becomes harder to treat due to the area’s complex anatomy and fewer established surgical options. In this report, we describe the case of a young adult patient with a rare form of osteosarcoma in the upper part of her ulna. Because traditional metal implants were not available and treatment could not be delayed, the surgical team used 3D printing technology to design a custom mold. This mold was used to shape a cement-based implant that matched the patient’s anatomy and allowed for functional reconstruction of her elbow. The patient recovered well and maintained good arm function over two years of follow-up. This case shows how 3D printing can offer affordable, personalized solutions in rare and urgent cancer surgeries, especially where resources are limited.
Abstract
Osteosarcoma is one of the most common primary bone malignancies, typically occurring around the knee. However, the forearm is a rare site, with tumors in the proximal ulna being extremely uncommon. Primary sarcoma in this location presents a surgical challenge due to the complex anatomy and limited reconstructive options. We report a rare case of a 19-year-old female with non-metastatic, high-grade giant cell-rich osteosarcoma involving the right proximal ulna. To our knowledge, this is only the second reported adult case of this histological subtype in this location. The patient was treated at a specialized oncology center with neoadjuvant and adjuvant chemotherapy, along with wide intra-articular resection for local tumor control. Reconstruction was achieved using a novel, customized 3D-printed articulating cement spacer mold with plate osteosynthesis. Artificial elbow ligamentous reconstruction was performed using FiberTape and FiberWire sutures passed through drill holes, and the triceps tendon was reattached to the cement mold using an endobutton. This cost-effective and personalized surgical approach allowed successful joint reconstruction while maintaining elbow stability and function. Our case highlights a feasible reconstructive option for rare and anatomically challenging osteosarcoma presentations, contributing to the limited literature on proximal ulna giant cell-rich osteosarcoma.
Keywords:
osteosarcoma; proximal ulna; 3D printing
