Eradication of advanced XXXX after limb salvage surgery - 5-year follow-up: a case report.

@entity1 @entity3753 @entity295 @entity174 @entity8434 @entity79 @entity12047 @entity4801
INTRODUCTION: @entity8434 is produced by the larval stage of @entity12047 ; it is a @entity4801 which is seen rarely in @entity1 and has adverse outcomes. We report a case of advanced @entity79 with successful limb salvage surgery. Our @entity1 had a 5-year follow-up without recurrence which is a rarity as per the literature. Early diagnosis and prompt medical therapy are necessary for effective management whereas delayed diagnosis is always fraught with the risk of recurrence and @entity295 . CASE PRESENTATION: In 2009, a 30-year-old @entity1 , native of Karachi (Sindhi ethnicity), presented at our clinic with history of a pathological @entity174 11 years earlier. Her @entity174 was initially misdiagnosed and fixed. Subsequently she had persistent disease that progressed with time. Following this she underwent multiple surgeries and the diagnosis of hydatid disease was made but despite multiple debridements and medical therapy she was not cured and finally she was offered a hemipelvectomy (limb sacrifice). On presentation to our hospital she was counseled regarding options of hemipelvectomy versus a limb salvage form of modified internal hemipelvectomy and wide margin resection. She opted for limb salvage. She underwent internal hemipelvectomy with wide margin resection of soft tissue and proximal femur along with postoperative @entity3753 therapy. She was able to walk again after a very long period. Currently she is 5-years postreconstructive surgery. She is infection free and ambulant without support. CONCLUSIONS: Hydatid @entity79 is a rare entity in our part of the world but a careful history and thorough look at the initial images of our @entity1 would have led to the suspicion of pathologic @entity174 and subsequent early diagnosis of this difficult problem. A second important learning point in this case was the lack of early referral to a center where this difficult problem could have been handled effectively. This could have minimized the physical, mental and financial stress to the @entity1 and her family.
