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Tuyển tập báo cáo các nghiên cứu khoa học quốc tế ngành y học dành cho các bạn tham khảo đề tài: Major surgery in an osteosarcoma patient refusing blood transfusion: case report | Dhanoa et al. World Journal of Surgical Oncology 2010 8 96 http www.wjso.eom content 8 1 96 WORLD JOURNAL OF SURGICAL ONCOLOGY CASE REPORT Open Access Major surgery in an osteosarcoma patient refusing blood transfusion case report Amreeta Dhanoa1 Vivek A Singh2 Rukmanikanthan Shanmugam2 Raja Rajendram3 Abstract We describe an unusual case of osteosarcoma in a Jehovah s Witness patient who underwent chemotherapy and major surgery without the need for blood transfusion. This 16-year-old girl presented with osteosarcoma of the right proximal tibia requiring proximal tibia resection followed by endoprosthesis replacement. She was successfully treated with neoadjuvant chemotherapy and surgery with the support of haematinics granulocyte colony-stimulating factor recombinant erythropoietin and intraoperative normovolaemic haemodilution. This case illustrates the importance of maintaining effective open communication and exploring acceptable therapeutic alternative in the management of these patients whilst still respecting their beliefs. Background Jehovah s Witnesses are well known in the medical world for their refusal on the acceptance of blood and blood products 1 . Unique aspects of these beliefs can pose health care providers with challenging medical legal and ethical dilemmas. Modifications of standard transfusion practices may be necessary to respect the beliefs of a Jehovah s Witnesses patient and this may be an impediment to optimal care of a patient. We describe here a 16-year-old Jehovah s Witness patient with osteosarcoma who required a major surgery and chemotherapy which we believe is the first reported such case. Case presentation Clinical presentation Miss S is a 16-year-old Chinese girl. She presented to a tertiary hospital with an initial complaint of progressively increasing pain and swelling of her right leg of 3 months duration. It was interfering with her right knee movement and walking. It was not associated with any significant trauma and started
