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POSTERIOR MYOCUTANEOUS RECONSTRUCTION FOLLOWING EXTERNAL HEMIPELVECTOMY IN A THIGH LEIOMYOSARCOMA: A CASE REPORT
Apresentação do caso
A 66-year-old man presented to the outpatient department with a local grade III recurrent leiomyosarcoma on left thigh. The first operation was performed five year ago. The patient reported painful tumor and physical examination revealed a tumor on medial of the left thigh extending to inguinal region. Computerized Tomography showed na infiltrative expanding lesiono on left inguinal region with 76x90mm. It was along with adductor muscle and with subcutaneous swelling. The patient underwent a external hemipelvectomy with posterior myocutaneous flap reconstruction. Patology result revealed leiomyosarcoma measuring 15/10cm, without bone invasion and with R0 resection. Pathology stading: III. The patient was submitted to adjuvant chemotherary.
Soft tissue sarcoma is a rare type of cancer. Usually begins in the tissues that connect or surround body structures. Sarcoma can appears anywhere in the body but the most commom types occur in the legs or arms. Surgical removal is the main treatment and chemotherapy and radiation are also recommended in some cases. The R0 resection is the unique curative method and the decision for external hemipelvectomy is often the best choise. As external hemipelvectomy is considered a extensive pelvic resection, with amputation included, several options for reconstruction are available. Is this case was developed the posterior flap included a muscular component, the gluteal muscles. The most commom complication associated with the lap is necrosis with following flap failure.
Hemipelvectomy is a procedure with considerable morbidity but was performed searching for a R0 ressection in this case. The reconstruction with a posterior flap with gluteal muscles was the appropriate choice. There was no flap complications and the operation may increase life expectancy.
hemipervectomy, leiomyosarcoma, flap, thigh
Tumores De Partes Moles e Retroperitônio
ANA THEREZA BISSOLI, RENATO MORATO ZANATTO, JUNEA CARIS OLIVEIRA, EDUARDO MARCUCCI PRACUCHO, GUSTAVO GARCIA DE ARRUDA FALCÃO, JUNIOR RODRIGUES SOARES, BEATRIZ MARTINHÃO HIGA, MAURICIO PEREIRA SILVA FILHO, VITOR AUGUSTO MELÃO MARTINHO, KARLA THAIZA TOMAL