Surgical Treatments

Soft Tissue Tumor Excision

Prior to removing any soft tissue tumor, your physician should have ordered and reviewed a scan (MRI, CT). Most patients will also have had a biopsy. The importance of the scans is to define the exact location of the tumor/mass and the biopsy allows us to know whether it is benign (non-cancerous) or malignant (cancerous) before performing your surgery.

You may here discussion of the “margins” of your tumor. This refers to the edge of the tumor when it is removed and indicates whether or not it has been completely removed. A “wide margin” is when the tumor has been removed with a cuff of normal tissue completely surrounding the tumor. This is the desired type of surgical margin for the removal of cancerous tumors (ie soft tissue sarcoma) and lessens the chance of the tumor recurring. A “marginal margin” is when the tumor has been removed exactly at its border with the normal tissue. Often this type of margin is seen when the tumor has a thick capsule or envelope. This type of margin is desirable for benign tumors such as a lipoma.

A “positive margin” indicates that the tumor has been cut through or has been removed very close to the edge but a small amount of tumor likely remains. This type of margin may be seen when removing a tumor which has grown against a nerve or artery which cannot be removed with the tumor.

Our physicians are experts in using your tests, scans and biopsy results to determine the most appropriate type of surgery for you. Since many of these tumors occur around joints and in muscle, we also have the specialty training and experience to remove each tumor while maximizing post-operative function of the muscle, joint or limb.

Limb Sparing Surgery

Thanks to the development of effective chemotherapy and new surgical techniques, most patients who previously would have required an amputation for the treatment of their bone or soft tissue cancers can now be treated without an amputation. Since many of these cancers occur around joints or within muscles, it is often necessary to remove segments of bones, joints or large portions of muscles. However, using our orthopaedic training we can reconstruct most bone or joint defects. We also direct intense physical therapy and occasionally use bracing to compensate or eliminate weakness of the muscle or joint.

Unfortunately, some patients will still require an amputation to completely remove the cancer from their body. Our physicians are experts in the techniques of amputation and work with highly skilled prosthetists in our area to provide high-tech, customized prosthetics for our patients.

Cutting Edge Technologies

In order to provide the best possible service to our patients, our physicians utilize the newest technologies when replacing large segments of bone or joints which have been removed due to cancer.

Dr. Mallin helped study Biomet’s Compress Device for fixation of replacement components to a patients remaining bone. This has now been used successfully in many of our patients and will hopefully avoid future surgeries to re-stabilize a patient’s implant. A brief description can be found here.

Dr. Seidel has been actively using a type of bone replacement for children which can grow as the child grows. The Repiphysis from Wright Medical has a spring loaded mechanism which expands when ultrasound is exposed to the leg. The expansion does not require an incision or surgery and is therefore less painful and does not risk infection. More information can be found here.

In order to provide the best possible service to our patients, our physicians utilize the newest technologies when replacing large segments of bone or joints which have been removed due to cancer.

Before retiring, Dr. Mallin helped study Biomet’s Compress Device for fixation of replacement components to a patients remaining bone. This has now been used successfully in many of our patients and will hopefully avoid future surgeries to re-stabilize a patient’s implant. A brief description can be found here.  Dr. Seidel now travels the country frequently to provide instruction to other physicians on how to use this cutting edge device.

Dr. Seidel has been actively using a type of bone replacement for children which can grow as the child grows. The Repiphysis from Wright Medical has a spring loaded mechanism which expands when an electromagnetic coil is exposed to the leg. The expansion does not require an incision or surgery and is therefore less painful and does not risk infection. More information can be found here.  Dr. Seidel has been working closely with Wright Medical with this device and has re-designed parts of the implant so as to provide better fixation to the bone.

Dr. Seidel and his resident, Dr. Webber published an article detailing the  first use of a combination of the compress and Repiphysis.  This data was also presented at the national meeting of the Musculoskeletal Tumor Society in November of 2008.  The scientific article can be found here http://www.healio.com and the Arizona Republic article can be found here http://www.azcentral.com.

For Dr. Seidel’s work in bringing two competing companies together for the benefit of his patients, he was awarded the Arizona Medical Societies Humanitarian Award.