(Kiosk 1) Not a Leg to Stand On: An Internal Hemipelvectomy

Case Diagnosis: Left Internal Hemipelvectomy in the Setting of Pleomorphic Sarcoma

Case Description or Program Description: A 69-year-old male suffering from hypertension, peripheral artery disease,
and prostate cancer status-post prostatectomy complained of left pelvic pain for several months.
His biopsy revealed pleomorphic sarcoma of the left pelvis. The patient underwent three cycles
of neoadjuvant chemotherapy with a mixed response and experienced episodes of neurotoxicity
that made him unable to complete further treatment. He underwent sarcoma resection, including
the left hemipelvis, with bladder and urethral mobilization and rectus flap creation followed by
pelvic radiation.

Setting: Acute Inpatient Rehabilitation Hospital

Assessment/Results: After undergoing a comprehensive rehabilitation program, the patient
was able to improve his functional status and learn techniques that increased his level of
independence after an extensive and life-alerting operation.

Discussion (relevance): Reconstruction of the pelvis after internal hemipelvecomy often involves creating
skin grafts/flaps to recreate the pelvic floor and protect remaining structures. Patients often
undergo a long healing process before being fitted with an internal prosthetic and have
extensive rehabilitation requirements

Conclusions: Internal hemipelvectomies allow patients to retain the lower extremity with the
goal of recreating and implanting a prosthetic hemipelvis. These prosthetics offer increased
support and stability and increase a patient’s likelihood of regaining functional independence.