J Korean Bone Joint Tumor Soc.  2012 Dec;18(2):72-77. 10.5292/jkbjts.2012.18.2.72.

Unplanned Excision of Soft Tissue Sarcoma: Patient Profile and Treatment Outcomes

Affiliations
  • 1Department of Orthopedic Surgery, Yonsei University College of Medicine, Seoul, Korea. choisidoru@yuhs.ac

Abstract

PURPOSE
Unplanned excision of a soft tissue sarcoma is defined as the operation performed for gross removal of a soft tissue sarcoma without regard for preoperative imaging or the necessity to removal a margin of normal tissue covering the cancer. We report our experience of treating primary soft tissue sarcoma after an unplanned excision.
MATERIALS AND METHODS
We retrospectively reviewed 31 patients referred to our hospital after unplanned excision at other hospitals for treatment of a STS. The clinical information was reviewed with a focus on the patient's age, gender, tumor location, tumor size, tumor depth, presumptive diagnoses at the previous surgery, refer hospital, definitive diagnosis, interval between the initial and additional surgery and local recurrence.
RESULTS
There were 19 males and 12 females with a median age of 48 years (range, 17-75 years) at the time of referral. Seventeen patients (54.8%) had tumors in their lower limb, 6 (19.4%) had tumors in their upper limb, and 8 (25.8%) had tumors in their trunk. Tumor depth could be determined for 8 patients (25.8%), with superficial and 22 deep tumors (71%). The medial interval between unplanned excision to re-excision ranged from 2 weeks to 1 year (median, 5 weeks). Local recurrence was detected in 2 patients. All patients were alive without metastasis at last follow up.
CONCLUSION
Even in upper class general hospital, many unplanned excision had been performed, which is considered to be avoided. When the relatively huge mass located in deeper layer it requires enough preoperative imaging studies and biopsy.

Keyword

soft tissue sarcoma; re-excision; unplanned excision

MeSH Terms

Biopsy
Female
Hospitals, General
Humans
Lower Extremity
Male
Neoplasm Metastasis
Recurrence
Referral and Consultation
Retrospective Studies
Sarcoma
Upper Extremity

Figure

  • Figure 1 Unplanned excision of thigh mass in a 17-year-old boy who was diagnosed alveolar soft part sarcoma. (A) Clinical photo shows longitudinal skin incision and inappropriate location of drain. (B) MRI which was done before re-excision shows massive hemorrhage. (C) Re-excision was done at 4 weeks later refer to our hospital. Final pathology reports residual alveolar soft part sarcoma, hemorrhage and foreign body type giant cell reaction. Resection margin was free from tumor (safety margin: 2 cm).


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