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Introduction and importance Xanthomas are a rare condition with the appearance of exogenous masses on the body, and it is common in patients with familial hypercholesterolemia (FH). For multiple large xanthomas, surgical excision is optimal to improve the patient's quality of life. Case presentation A 34-year-old male patient presented with multiple large tuberous xanthomas related to FH. There were 15 masses in different body parts, including the dorsum of the hands, elbows, buttocks, feet, and Achille's tendon. The largest masses in the buttocks measured 8 × 8 × 5 cm. Surgical removal of 13 masses was carried out in combination with medical treatment. The skin incision was oval around the circumference of masses with the longitudinal axis parallel to the Langer's line. Skin defects were closed directly or dissected on both sides of the incision to reduce tension. Wound healing was normal. After 1.5 months, there was no recurrence of xanthomas. Clinical discussion Surgical treatment easily removes the entire tuberous xanthomas. The healing process is completely normal. Resection should be indicated for tuberous xanthomas that cause negative functional and aesthetic effects. Besides, lipid-lowering therapy is necessary to prevent tuberous xanthomas recurrence as well as premature coronary artery diseases. Conclusion Surgical treatment of patients with multiple large tuberous xanthomas related to familial hypercholesterolemia was performed safely and successfully. After 1.5 months of follow-up, the wound healed well and no recurrence of xanthomas was detected. We recommend that a further study is needed to investigate post-treatment recurrence for multiple large xanthomas., Highlights • Surgical treatment for multiple large tuberous xanthomas • A 34-year-old male patient with masses in different locations of the body • No recurrence of xanthomas after 1.5 months follow-up

Introduction and importance: Pelvic osteosarcoma is quite rare and is a challenging task for orthopedic surgeons. This aim of this study is to present the first case report using customized 3D-printed prosthesis in Vietnam. Case presentation 57-year-old male was diagnosed with pelvic osteosarcoma. After neoadjuvant chemotherapy, we did limb-salvage surgery after partial pelvic resection. He had to undergo another surgery due to an infection complication that exposed part of the prosthesis. At 6 months follow-up, the patient's overall status was stable. VAS score when moving is 2/10. He can walk with one crutch. Patient is still being followed up and treated. Clinincal discussion Management of pelvic osteosarcoma remains a challenging task for orthopedic surgeons. Advancements in customized 3D-printed prosthesis have been applied in treatment of pelvic osteosarcoma. Despite the complications, the results are promising. We believe that this is a new and innovative route in surgery of pelvic osteosarcoma. Conclusion Using customized 3D-printed prosthesis is a good way for management of pelvic osteosarcoma., Highlight • Osteosarcoma of pelvis is not common, account for 4–10% of all bone cancer. • Pelvis connect the lower limb with body by hip joint and support the intraabdominal organ. • It is very difficult to preserve the pelvis after wide resection. • Custom made 3D printed implant give us a chance to restore the pelvis anatomically and functionally.

Introduction and importance The partial androgen insensitivity syndrome (PAIS) is a rare genetic disorder, which needs to be diagnosed early and provided suitable treatment. One-stage sex reassignment surgery can be considered as one of the treatment options for PAIS patients. Case presentation A 44-year-old patient with PAIS was admitted to our hospital. After getting a consultation, the patient decided to choose the one-stage sex reassignment surgery to be reassigned to be a female. The surgery consisted of breast augmentation and genital surgery. After 8 months of follow-up, the patient's breast had a desired shape and volume. The clitoris was in normal size with normal sensation, and the neovagina was 8 cm in depth with a smooth mucosal surface. We also observed that the minor labia were symmetric. The patient reported achieving orgasms with sex toys. Clinical discussion The one-stage sex reassignment surgery for the PAIS patient is safe and reduces treatment time for patients. It could also bring many benefits to the patients, such as reducing the incision, preventing gonadoblastoma and giving a sense of the patient's female gender which helps the patient feel confident and improve her quality of life. Thus, the one-stage surgery should be indicated for the patient at middle-aged who shouldn't be delayed anymore to have normal female breast and external genitalia. Conclusion The one-stage sex reassignment surgery was performed safely and successfully on the delayed presentation of the PAIS patient. This could be an effective and appropriate approach to treat late-diagnosed PAIS patients., Highlights • One-stage sex reassignment surgery for a patient with partial androgen insensitivity syndrome • A 44-year-old patient at the delayed presentation of the disorder • We observed good treatment outcomes with a 8-moth follow-up

The authors reviewed their experience with tissue expansion from July of 1995 to December of 1999 at Hanoi Plastic Surgery Center. A total of 75 tissue expanders of various sizes were placed in 50 consecutive patients (16 men and 34 women) for the reconstruction of secondary defects (burn scars, skin graft scars, hypertrophic scars, keloids, capillary hemangioma, congenital nevi and micotia). The average age of patients was 21 years. The tissue expansion protocol was used in clinical as well as common principle. The main technical details are modified in this procedure by the authors: type of intralesional incision for expander insertion, closing of wound incision by three layers, evacuation of the liquid in the prosthesis pocket, injection with antibiotic solution and expanded flap capsulectomy. The complications rate was 10.6% (8 complications in 75 expanders). The most common complications consisted of infection, hematoma, exposure of valve, dehiscence of incision, necrosis of the distal expanded flap. The overall failure rate was 8%. Thus our modified surgical details allowed us to decrease the major complications and to achieve the best possible functional and aesthetic results.