Limb Salvage Surgery in a Rare Case of Recurrent Parosteal Osteosarcoma with Vascular Graft Thrombosis
Recurrent parosteal sarcomas with vascular involvement are rare and present unique challenges in their diagnosis and management. We report the case of a 21-year-old woman with parosteal osteosarcoma of the left distal femur, encasing the popliteal vessels. En bloc transarticular resection of the dis...
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| Format: | Article |
| Language: | English |
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Medrang
2023-11-01
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| Series: | Vascular Specialist International |
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| Online Access: | http://www.vsijournal.org/journal/view.html?doi=10.5758/vsi.230058 |
| _version_ | 1797635899551383552 |
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| author | Gaurav Ravi Kumar Chandra Kumar Krishnan Krishna Muralidharan Shirley Sundersingh Karthigaiselvi Murugesan Anand Raja |
| author_facet | Gaurav Ravi Kumar Chandra Kumar Krishnan Krishna Muralidharan Shirley Sundersingh Karthigaiselvi Murugesan Anand Raja |
| author_sort | Gaurav Ravi Kumar |
| collection | DOAJ |
| description | Recurrent parosteal sarcomas with vascular involvement are rare and present unique challenges in their diagnosis and management. We report the case of a 21-year-old woman with parosteal osteosarcoma of the left distal femur, encasing the popliteal vessels. En bloc transarticular resection of the distal femur and popliteal vessels was performed, followed by reconstruction using a modular prosthesis and a saphenous vein autograft for both the artery and vein. On the 1st postoperative day, the patient developed an arterial thrombus requiring reintervention with a jump polytetrafluoroethylene (PTFE) graft. Histopathology confirmed parosteal osteosarcoma. After a disease-free survival of 41 months, the patient experienced local recurrence involving the PTFE graft, leading to graft compression, erosion, and subsequent thrombosis. Despite these complications, limb salvage was possible due to adequate collateral blood supply. This case highlights the feasibility of limb salvage surgery in select cases of parosteal osteosarcoma with vascular involvement. |
| first_indexed | 2024-03-11T12:27:32Z |
| format | Article |
| id | doaj.art-64513d19d21c4cef94a71c1422e9b9de |
| institution | Directory Open Access Journal |
| issn | 2288-7970 2288-7989 |
| language | English |
| last_indexed | 2024-03-11T12:27:32Z |
| publishDate | 2023-11-01 |
| publisher | Medrang |
| record_format | Article |
| series | Vascular Specialist International |
| spelling | doaj.art-64513d19d21c4cef94a71c1422e9b9de2023-11-06T07:43:06ZengMedrangVascular Specialist International2288-79702288-79892023-11-013910.5758/vsi.230058vsi.230058Limb Salvage Surgery in a Rare Case of Recurrent Parosteal Osteosarcoma with Vascular Graft ThrombosisGaurav Ravi Kumar0Chandra Kumar Krishnan1Krishna Muralidharan2Shirley Sundersingh3Karthigaiselvi Murugesan4Anand Raja5Department of Surgical Oncology, Cancer Institute (W.I.A), Adyar, Chennai, Tamil Nadu, IndiaDepartment of Surgical Oncology, Cancer Institute (W.I.A), Adyar, Chennai, Tamil Nadu, IndiaDepartment of Vascular Surgery, Tamil Nadu Government Multi-Superspeciality Hospital, Omandurar Estate, Chennai, Tamil Nadu, IndiaDepartment of Onco-Pathology, Cancer Institute (W.I.A), Adyar, Chennai, Tamil Nadu, IndiaDepartment of Radiology, Cancer Institute (W.I.A), Adyar, Chennai, Tamil Nadu, IndiaDepartment of Surgical Oncology, Cancer Institute (W.I.A), Adyar, Chennai, Tamil Nadu, IndiaRecurrent parosteal sarcomas with vascular involvement are rare and present unique challenges in their diagnosis and management. We report the case of a 21-year-old woman with parosteal osteosarcoma of the left distal femur, encasing the popliteal vessels. En bloc transarticular resection of the distal femur and popliteal vessels was performed, followed by reconstruction using a modular prosthesis and a saphenous vein autograft for both the artery and vein. On the 1st postoperative day, the patient developed an arterial thrombus requiring reintervention with a jump polytetrafluoroethylene (PTFE) graft. Histopathology confirmed parosteal osteosarcoma. After a disease-free survival of 41 months, the patient experienced local recurrence involving the PTFE graft, leading to graft compression, erosion, and subsequent thrombosis. Despite these complications, limb salvage was possible due to adequate collateral blood supply. This case highlights the feasibility of limb salvage surgery in select cases of parosteal osteosarcoma with vascular involvement.http://www.vsijournal.org/journal/view.html?doi=10.5758/vsi.230058limb salvageosteosarcomarecurrencethrombosispolytetrafluroethylene |
| spellingShingle | Gaurav Ravi Kumar Chandra Kumar Krishnan Krishna Muralidharan Shirley Sundersingh Karthigaiselvi Murugesan Anand Raja Limb Salvage Surgery in a Rare Case of Recurrent Parosteal Osteosarcoma with Vascular Graft Thrombosis Vascular Specialist International limb salvage osteosarcoma recurrence thrombosis polytetrafluroethylene |
| title | Limb Salvage Surgery in a Rare Case of Recurrent Parosteal Osteosarcoma with Vascular Graft Thrombosis |
| title_full | Limb Salvage Surgery in a Rare Case of Recurrent Parosteal Osteosarcoma with Vascular Graft Thrombosis |
| title_fullStr | Limb Salvage Surgery in a Rare Case of Recurrent Parosteal Osteosarcoma with Vascular Graft Thrombosis |
| title_full_unstemmed | Limb Salvage Surgery in a Rare Case of Recurrent Parosteal Osteosarcoma with Vascular Graft Thrombosis |
| title_short | Limb Salvage Surgery in a Rare Case of Recurrent Parosteal Osteosarcoma with Vascular Graft Thrombosis |
| title_sort | limb salvage surgery in a rare case of recurrent parosteal osteosarcoma with vascular graft thrombosis |
| topic | limb salvage osteosarcoma recurrence thrombosis polytetrafluroethylene |
| url | http://www.vsijournal.org/journal/view.html?doi=10.5758/vsi.230058 |
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