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3D Printed Chondrosarcoma of Scapula
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3D Printed Chondrosarcoma of Scapula
Clinical History
A 60-year old female presented with a 12-month history of recurrent pain and
increasing swelling in her right shoulder. On examination, there was a palpable mass over the superior aspect of her
right scapula. There was limitation of abduction and external rotation at the shoulder joint. There was no palpable
lymphadenopathy. X-ray of her shoulder showed a mass involving the superior scapula above the spine. The mass was
biopsied and the scapula was completely excised.
Pathology
The specimen is the patient’s excised right scapula. An irregular lobulated tumour 11
cm in maximum diameter arises from the spine of the scapula and extends to involve the acromion and coracoid
process. The tumour is a mottled pale-yellow brown colour with patchy surface haemorrhage. There is some adherent
muscle and fibrous tissue. The mass has infiltrated and replaced the normal bone. Histologically the tumour
consisted of pleomorphic rounded and spindle-shaped cells with numerous mitotic figures and cartilage formation.
This is chondrosarcoma of the scapula.
Further Information
Chondrosarcomas are malignant bone tumours that produce cartilage. These are
the third most common primary bone malignancy after myeloma and osteosarcoma. Conventional tumours are the most
common subtype of chondrosarcoma; making up 90% of cases. Less frequently diagnosed subtypes include clear cell,
dedifferentiated and mesenchymal chondrosarcomas.
Some chondrosarcomas arise from pre-existing benign lesions,
such as enchondroma or osteochondroma. Common mutations in chondrosarcomas are point mutations in the IDH1 and IDH2
genes as well as silencing of CDKN2A tumour suppressor gene. Chondrosarcomas that occur in multiple osteochondroma
syndrome have mutations in the tumour suppressor EXT genes. Men are twice as likely to develop chondrosarcoma than
women. The axial skeleton is more frequently affected than the appendicular skeleton. Around 5% affect the scapula.
These are largely slow growing tumours. They usually present with painful and gradually enlarging masses. At the
time of diagnosis most are low grade tumours that rarely metastasize. The lungs are the most common site for distant
spread. Grade 1 tumours have an almost 90% 5-year survival rate, whereas with grade 3 chondrosarcomas, the 5-year
survival rate drops to 43%.
CT scan is the optimal radiological investigation for diagnosis with MRI also frequently used. Biopsies may be taken to assist diagnosis. Treatment depends on the grade and the location of the tumour. Complete surgical resection is the standard treatment. Generally, chondrosarcomas do not respond to chemotherapy or radiotherapy given they are very slow growing tumours.
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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.