Purpose: The prognosis is dramatic in patients with malignant Schwannoma. These tumours appear to progress invariably irrespective of the complementary treatment given. In order to determine whether this clinical impression is founded, we reviewed retrospectively patients cared for conjointly by the Cochin Hospital and the Curie Institute since 1956.

Material and methods: This series included 32 patients (17 men and 15 women) including seven who had a Recklinghausen neurofibromatosis (three men and four women). The logrank test was used to compare the actuarial survival curves and determine prognostic factors and potential benefit of chemotherapy and radiotherapy protocols.

Results: Mean age at diagnosis was 42.1 years (11.8–78.9). Ten percent of the schwannomas were grade I, 25% grade II and 65% grade III. All patients except two underwent surgery. The resection was considered wide in three cases, marginal in 17, contaminated in seven and non-classifiable in three. There were 14 cases of local recurrence within a mean delay of 12 months (1–66 months). Twelve patients developed secondary local relapse within a mean delay of 36 months (0–169 months). Different neoadjuvant or adjuvant treatments were administered, including chemotherapy and radiotherapy. Twenty-four patients died with a median survival of 25 months. The survival curves showed that complementary treatments did not significantly improve survival. The only factor with prognostic value was the histological grade and the quality of the resection.

Discussion: Our findings are in general agreement with data in the literature demonstrating the lack of efficacy of complementary treatments in patients with malignant schwannomas. Inversely Recklinghausen disease did not appear to modify prognosis in our patients.

Purpose: We report oncological and functional outcome after ten pelvis reconstructions using the Puget technique.

Material and methods: Ten patients (six men and four women), mean age 50 years (37–71) with malignant bone tumours, generally a chondrosarcoma, were included in this series. The tumour involved zone II in five patients, zones II and III in the other five. Resection was followed by reconstruction using the superior portion of the homolateral femur and a cemented total hip arthroplasty. Mean resection was 13 cm (7–23). Mean operative time was 386 min and mean blood loss was 5490 ml. The resection was wide in seven patients, marginal in two and resection margins were contaminated in one. The patients were reviewed at three, six and twelve months then each year. The function score (Enneking) was recorded for all patients. Living patients also filled out a TESS quality of life questionnaire.

Results: At mean follow-up of 22 months (7–42), four patients were living and disease free and two patients were living with recurrent disease. Three patients had died from their disease and one from pulmonary embolism. Postoperative complications were: one dislocation, one phlebitis, one reflex dystrophy, one injury to the internal genital nerve, two infections and one necrosis of the scar tissue. Bone healing was obtained at a mean five months. The mean Enneking function score was 68% and the mean TESS score was 75%.

Discussion: The high proportion of deaths is related to the severe prognosis of these pelvic tumours. This reconstruction technique described by Puget, provides an interesting alternative to other reconstruction methods for the acetabular region. The autogenous graft combined with a standard total hip arthroplasty makes this a rather easy to perform and low-cost procedure.

Conclusion: Functional outcome has been, in our experience, better than with arthrodesis, acetabular prosthesis, or saddle prosthesis and massive allograft of the pelvis.