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Comprehensive palliative treatment on Ewing sarcoma patient post forequarter amputation


MOJ Clinical & Medical Case Reports
Sigit Daru Cahayadi,1 Muhammad Reza Saputra2

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Abstract

1.1 Introduction: Ewing’s sarcoma is one of the most progressive cancer which prevalence on children and adolescent. This condition causes metastasis on other part of organ such as brain and lung. Because of it progressivity, clinical presentation can be painful, thus, decreasing quality of life and metastasis. In order to decrease the psychological burden and adverse effect, a comprehensive palliative care is needed. 
1.2 Methods: We reported a a male patient aged 15 years old. The patient was diagnosed with fracture on humerus sinistra and treated by giving cast after a futsal accident .One month afterwards, swellings and pain was increased in intensity so the suspicion changed into compartment syndrome. Therefore, fasciotomy was done. A number of examinations and clinocipathological conference (CPC) produce a conclusion Ewing’s Sarcoma. The patient had finally undergone for equarter amputation surgery. Then the patient was treated with chemotherapy, however could not continue second procedure of chemotherapy as the patient died before the procedure.
1.3 Discussion: Palliative care on Ewing’s sarcoma patient gives advantage when curative treatment does not work out. The progression of Ewing’s sarcoma caused metastasis in other organ, the objective of palliative care itself is to prevent symptoms and minimalize the impact of treatment on quality of life. On this patient’s case, the patient could be given necessary care if misdiagnosis did not happen earlier. The proper diagnosis affects outcome of the disease thus the patient got appropriate treatment and care needed.
1.4 Conclusion: Palliative therapy on patient with Ewing’s sarcoma gives advantage to patient especially in terms of quality of life and life expectancy. Patient who undergo forequarter amputation will have hard time to adjust their life outside the hospital settings. Palliative therapy of choice are included surgery, radiotherapy, chemotherapy, and administration of pain-killer administration with addition of psychotherapy and medical rehabilitation

Keywords

Ewing sarcoma, humerus, chemotherapy, translocation, psychological reaction, emotional burden, impairment

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