Abstract
Myxofibrosarcoma is one of the most common sarcomas in elderly patients showing a slight male prevalence. The tumor is mainly located in lower and upper extremities and rarely in trunk, neck and feet. We present a case of a 84-year-old man referred to our tumour center with a giant and neglected high-grade tibial myxofibrosarcoma in the anteromedial side of tibial mid-diaphysis. Large size lesions in association with older age may jeopardise the maintenance of limb vitality, vascularity and stability.Authors performed a complete tumour resection, followed by reconstruction of bone and soft tissue defects with cement, plate and a musculocutaneous gastrocnemius flap, in order to cover the underlying bone and promote uneventful healing and perfusion of the operated extremity.At 2 years postoperatively, limb salvage, good functional outcome and no tumour recurrence were reported while the patient was able to effectively perform the majority of the daily activities.
Highlights
Myxofibrosarcoma is one of the most common sarcomas in elderly patients showing a slight male prevalence [1]
Myxofibrosarcoma was firstly described by Weiss and Enzinger as a myxoid variant of malignant fibrous histiocytoma (MFH) [1]
Large size lesions in association with older age may jeopardise the maintenance of limb vitality, vascularity and stability
Summary
Myxofibrosarcoma is one of the most common sarcomas in elderly patients showing a slight male prevalence [1]. Complete tumour resection was followed by reconstruction of bone and soft tissue defects with cement and a musculocutaneous gastrocnemius flap, respectively. The lesion was painless and the patient reported a rapid increase in its size during the last year. Before that time, he did not worry of its nature, as it was remained unchanged for many years. Tumour removal was followed by coverage of the large remaining soft tissue and skin defect (25 cm) with a microvascular musculocutaneous flap from the contralateral thigh. The patient was scheduled to undergo surgical resection of the lesion with additional removal of the adjacent soft tissue structures. B) Postoperative evaluation: coverage of soft tissue and skin defect with a micro vascular musculocutaneous flap.
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