Extensive Periosteum-Stripping Resection Without Prophylactic Femur Fixation in Thigh Tumors

Özger H., ALPAN B.

Diagnosis and Treatment of Soft Tissue Tumors: Changes, Challenges and Strategies, Springer International Publishing Ag, ss.393-401, 2025 identifier

  • Yayın Türü: Kitapta Bölüm / Araştırma Kitabı
  • Basım Tarihi: 2025
  • Doi Numarası: 10.1007/978-3-031-77061-6_43
  • Yayınevi: Springer International Publishing Ag
  • Sayfa Sayıları: ss.393-401
  • Anahtar Kelimeler: Bone involvement, Functional outcome, Iatrogenic fracture, Osteonecrosis, Periosteum stripping, Pleomorphic sarcoma, Prophylactic fixation, Radiotherapy, Soft tissue sarcoma, Wide resection
  • Acıbadem Mehmet Ali Aydınlar Üniversitesi Adresli: Evet

Özet

Pleomorphic sarcomas are high-grade soft tissue sarcomas (STSs), for which the primary treatment components are radiotherapy and surgery. Lower extremities, especially the thigh, constitute a typical localization for STSs. In this chapter, we present a 31-year-old male patient with a large pleomorphic sarcoma of the thigh, partially encasing his femur diaphysis. The case could be managed with various limb salvage strategies. Preserving the femur rather than replacing it with a tumor prosthesis required margin modification with neoadjuvant treatment. On the other hand, whether to perform a prophylactic fixation of the femur in a case with preoperative radiotherapy and periosteum-stripping resection is another crucial decision regarding radiation-induced osteonecrosis and fracture versus implant-related disadvantages.