Tratamento cirúrgico de um leiomiossarcoma do membro inferior

Mariana Moutinho , Emanuel Silva , Pedro Amorim , Hugo Freitas , Ana Evangelista , José Fernandes e Fernandes
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Abstract

Introduction

The lower limb sarcomas represent the most common location of tumors of the connective tissue and no other treatment proved to be better than surgery. The objective of this paper is to present a case of leiomyosarcoma located in the left thigh of a 59 year old woman.

Case report

The authors describe the case of a 59 year old woman, asymptomatic until January 2013, when a swelling, painless and progressive growth in the left thigh has been identified. No signs of neuro‐vascular compromise. A mass with 10 cm diameter, adhering to the deep planes, without pulsatility, has been identified through physical examination. She had no palpable lymphadenopathy and pulses were present and symmetrical. MRI revealed a solid lesion in intermuscular plane designed along the vascular‐nervous pedicle. The incisional biopsy confirmed a leiomyosarcoma. Together with the Plastic Surgery service a wide resection of leiomyosarcoma was performed followed by reconstruction of the SFA and the FV with interposition of the contralateral great saphenous vein in femoro‐femoral position. The procedure was held without significant complications.

Discussion and conclusion

Leiomyosarcomas are malignant and locally aggressive, therefore the extended resection (no touch no see) has been proved to be the best therapeutic option, as a multidisciplinary approach in order to achieve the cure with functional preservation of the member even with radical resections becomes indispensable.

下肢平滑肌肉瘤的外科治疗
下肢肉瘤是结缔组织肿瘤最常见的部位,没有其他治疗被证明比手术更好。本文的目的是提出一个病例平滑肌肉瘤位于左大腿59岁的妇女。病例报告作者描述了一名59岁女性的病例,直到2013年1月才出现症状,当时发现左大腿肿胀,无痛且进行性生长。没有神经血管损伤的迹象。体格检查发现一个直径10厘米的肿块,附着于深平面,无搏动。她没有可触及的淋巴结病变,脉搏存在且对称。MRI显示沿血管神经蒂的肌间平面有实性病变。切口活检证实为平滑肌肉瘤。与整形外科服务一起进行了平滑肌肉瘤的大范围切除,随后重建SFA和FV,并在股股位置插入对侧大隐静脉。手术过程无明显并发症。讨论与结论平滑肌肉瘤是恶性的,局部侵袭性的,因此扩大切除(无触无见)已被证明是最好的治疗选择,为了实现治愈,即使根治性切除也要保留成员的功能,多学科合作是必不可少的。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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