Clin Orthop Relat Res. 2013 Mar;471(3):832-3. doi: 10.1007/s11999-012-2732-6.
The Classic: Case of osteo-sarcoma of tibia, recurring in stump of thigh, and probably affecting the lung. 1878.
Clinical orthopaedics and related research
John Ewens
PMID: 23229428
PMCID: PMC3563821 DOI: 10.1007/s11999-012-2732-6
Abstract
This Classic article is a reprint of the original work by Mr. John Ewens, "Case of Osteo-Sarcoma of Tibia, Recurring in Stump of Thigh, and Probably Affecting the Lung." The case is of interest, because the findings contradicted an existing idea, "that large malignant growths, springing from the long bones, do not, after amputation, if the whole of the diseased structures be removed, return in the stump, but at some distant part; and, therefore, it is not necessary to amputate above the knee in the case of the tibia, or at the hip-joint in the case of the femur." In Mr. Ewen's case, an osteosarcoma of the tibia was treated with above-the-knee amputation, but, in fact, it recurred in the stump. The mechanism was unclear but could have arisen from the presence of a multifocal lesion in the femur, seeding at the time of amputation (details of the amputation were not provided, although the site of the tumor was apparently not involved), or perhaps subsequent metastasis from elsewhere to the stump. Mr. Ewens was a surgeon at the Hospital for Sick Children in Bristol, England. (No other information on Mr. Ewens could be located, and we have no accompanying biographical sketch.) The Classic Article is © (1878) and is reprinted from Ewens J. Case of Osteo-Sarcoma of Tibia, Recurring in Stump of Thigh, and Probably Affecting the Lung. Brit Med J. 1878; Feb 9;1(893):192-193.
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