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Leiomyosarcomas affecting main vessels in the lower extremities
R Rojas Sayol1, L Trullols Tarragó1, A Grau Blanes1
1Unidad de Cirugía Ortopédica Oncológica, Servicio de Cirugía Ortopédica y Traumatología, Hospital de la Santa Creu i Sant Pau, Universidad Autónoma de Barcelona, Barcelona, España.
Summary
Vascular leiomyosarcomas are aggressive tumors requiring limb-salvaging surgery. Despite bloc resection and vascular reconstruction, high rates of dissemination and recurrence were observed in this study.
Area of Science:
- Vascular Surgery
- Surgical Oncology
- Oncology
Background:
- Leiomyosarcomas involving major lower extremity vessels are rare but aggressive.
- Early diagnosis and surgical intervention are crucial for limb salvage and patient outcomes.
Purpose of the Study:
- To evaluate the efficacy of bloc resection and vascular reconstruction for lower extremity vascular leiomyosarcomas.
- To analyze complications, recurrence rates, and survival in patients undergoing these procedures.
Main Methods:
- Retrospective analysis of 6 patients with vascular leiomyosarcomas of the lower extremities diagnosed between 1983 and 2016.
- Inclusion of epidemiological data, imaging, surgical procedures, adjuvant treatments, and follow-up information.
Main Results:
- All tumors were high-grade (FNCLCC II-III) with an average diameter of 9.1 cm.
- Limb salvage was achieved in all cases, but 50% developed pulmonary metastasis and 33% hepatic metastasis.
- Local recurrence occurred in one case, with two deaths and one loss to follow-up.
Conclusions:
- Vascular leiomyosarcomas are highly aggressive with poor 5-year survival rates.
- Bloc resection and vascular reconstruction are necessary for limb salvage but are associated with significant metastatic potential.
- Thromboembolic phenomena are a frequent presenting symptom alongside palpable tumor mass.
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