Description
Clinical History
A 60-year old female presented with a 12-month history of recurrent pain and increasing swelling in her right shoulder. On examination, there was a palpable mass over the superior aspect of her right scapula. There was limitation of abduction and external rotation at the shoulder joint. There was no palpable lymphadenopathy. X-ray of her shoulder showed a mass involving the superior scapula above the spine. The mass was biopsied and the scapula was completely excised.
Pathology
The specimen is the patient's excised right scapula. An irregular lobulated tumor 11 cm in maximum diameter arises from the spine of the scapula and extends to involve the acromion and coracoid process. The tumor is a mottled pale-yellow brown color with patchy surface hemorrhage. There is some adherent muscle and fibrous tissue. The mass has infiltrated and replaced the normal bone. Histologically the tumor consisted of pleomorphic rounded and spindle-shaped cells with numerous mitotic figures and cartilage formation. This is chondrosarcoma of the scapula.
Further Information
Chondrosarcomas are malignant bone tumors that produce cartilage. These are the third most common primary bone malignancy after myeloma and osteosarcoma. Conventional tumors are the most common subtype of chondrosarcoma; making up 90% of cases. Less frequently diagnosed subtypes include clear cell, dedifferentiated and mesenchymal chondrosarcomas.
Some chondrosarcomas arise from pre-existing benign lesions, such as enchondroma or osteochondroma. Common mutations in chondrosarcomas are point mutations in the IDH1 and IDH2 genes as well as silencing of CDKN2A tumor suppressor gene. Chondrosarcomas that occur in multiple osteochondroma syndrome have mutations in the tumor suppressor EXT genes. Men are twice as likely to develop chondrosarcoma than women. The axial skeleton is more frequently affected than the appendicular skeleton. Around 5% affect the scapula. These are largely slow growing tumors. They usually present with painful and gradually enlarging masses. At the time of diagnosis most are low grade tumors that rarely metastasize. The lungs are the most common site for distant spread. Grade 1 tumors have an almost 90% 5-year survival rate, whereas with grade 3 chondrosarcomas, the 5-year survival rate drops to 43%.
CT scan is the optimal radiological investigation for diagnosis with MRI also frequently used. Biopsies may be taken to assist diagnosis. Treatment depends on the grade and the location of the tumor. Complete surgical resection is the standard treatment. Generally, chondrosarcomas do not respond to chemotherapy or radiotherapy given they are very slow growing tumors.
Advantages
- Anatomically accurate and identical to real specimen
- No ethical issues - not real human body parts
- Reasonably priced
- Available within a short lead time
- Reproducible, several identical prints can be used as a classroom set
- Can be produced in different sizes to cater for the needs of the teacher
Human Cadavers
- Access to cadavers can be problematic. Many countries cannot access cadavers for cultural and religious reasons
- Cadavers cost a lot money
- High cost for establishing your own plastination suite
- Wet specimens cannot be used in uncertified labs
- Dissection of cadavers is a lot of staff time and that is a cost
- Storage of cadaver material needs special refrigeration etc. which has coast
- If you want another specimen you have to start all over again
Plastinates
- Costs
- Ethical issues
- Timeframe for plastination process
- Many countries do not allow their importation
- One of a kind
Superior 3D print results compared with conventional methods
- Vibrant color offering with 10 million colors
- UV-curable inkjet printing
- High quality 3D printing that can create products that are delicate, extremely precise and incredibly realistic
Clear Support Material
- To avoid breakage of fragile, thin, and delicate arteries, veins or vessels, a clear support material is printed on such spots. This makes the models robust and can be handled by students easily.
