Abstract
BackgroundThe diagnosis of deep vein thrombosis of leg is very common in clinical practice. Not infrequently a range of pathologies are diagnosed after excluding a thrombosis, often after a period of anticoagulation.Case presentationThis is a report of three patients who presented with a painful swollen leg and were initially treated as a deep vein thrombosis or a baker's cyst, but later diagnosed as a pleomorphic sarcoma, a malignant giant cell tumor of the muscle and a myxoid liposarcoma. A brief review of such similar reports and the relevant literature is presented.ConclusionA painful swollen leg is a common clinical scenario and though rare, tumors must be thought of without any delay, in a duplex negative, low risk deep vein thrombosis situation.
Highlights
The diagnosis of deep vein thrombosis of leg is very common in clinical practice
We report three case histories of patients managed initially as a Deep vein thrombosis (DVT) of calf or a baker's cyst and later referred to our centre with a provisional diagnosis of a soft tissue tumor
The D-dimers were normal and a Doppler scan ruled out a DVT, but a baker's cyst was diagnosed
Summary
Painful swollen leg is a common clinical scenario. Deep vein thrombosis (DVT) often presents as a painful swollen leg and prompt management is vital to prevent fatal pulmonary embolism. We report three case histories of patients managed initially as a DVT of calf or a baker's cyst and later referred to our centre with a provisional diagnosis of a soft tissue tumor. After 3 weeks of anticoagulation there was evidence of a lump in the left popliteal fossa and ultrasound scan of the area revealed a solid soft-tissue mass. The D-dimers were normal and a Doppler scan ruled out a DVT, but a baker's cyst was diagnosed Following this episode the symptoms never settled and he was later reviewed for a sudden increase in size of the calf 4 years later. An MR scan revealed a heterogenous soft tissue mass probably of fatty origin in the posterior compartment measuring 10 × 25 cm (Figure 4A &4B) This was confirmed to be a low grade Myxoid Liposarcoma on biopsy.
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