At the tender age of 17, Aslam Mallick was in unbearable pain with swelling over his right thigh and knee since March 2024, and was unable to go to college. He underwent a biopsy in Mumbai and was diagnosed with osteosarcoma of the right distal femur with a pathological fracture.

Aslam, who had no other medical history or any co-morbidity, arrived at the OPD of Narayana Hospital, Howrah, after receiving 1 cycle of chemotherapy and was still in acute pain. An MRI scan of the right femur revealed high-grade osteosarcoma, which on PET scan was found to be nonmetastatic.

“We started him on neoadjuvant chemotherapy of 3 cycles followed by surgical excision and thereafter, another 4 cycles of adjuvant chemotherapy,” says Dr Nishith Praveenchandra Gupta, Consultant - Musculoskeletal Oncology, at Narayana Hospital, Howrah.

The tumour involved the distal femur and knee joint with a pathological fracture, which led to contamination of surrounding structures. “Hence, saving the knee joint while ensuring complete removal of the tumour was the top priority. Another challenge was reconstruction after removal of the tumour. It required resection of the distal femur and reconstruction with a megaprosthesis,” explains Dr Gupta.

The surgical procedure took 6 hours. Post-surgery, the patient was discharged and later, after suture removal, underwent adjuvant chemotherapy of 4 cycles. In all, Aslam stayed in hospital for 8 days.

“The tumour was located very close to the joint and blood vessels. As a result, ensuring complete removal of the tumour and preserving the knee joint was a big challenge. We achieved that by a distal femur megaprosthesis,” says Dr. Gupta. The patient has now completed treatment and is on follow-up. He is planning to go back to college soon.