Multi-Step Combined Upfront Surgery for Locally Advanced Paravertebral Sarcoma: A Case Report

Area of Science:

• Oncology
• Surgical Oncology
• Orthopedic Oncology

Background:

• Paravertebral undifferentiated pleomorphic sarcoma (UPS) with bone and vascular invasion presents significant surgical challenges due to its rare and complex location.
• Multi-step surgical procedures offer a potential strategy for achieving sustained local tumor control in challenging sarcoma cases.

Observation:

• A 62-year-old male patient presented with paravertebral UPS infiltrating the aortic wall and the 9th thoracic vertebra.
• The patient underwent a complex, multi-step surgical intervention involving thoracic, vascular, and spinal surgeons.

Findings:

• The surgical procedure included aortic resection with bypass grafting and triple en bloc vertebrectomy with tumor excision.
• Oncologic radicality was achieved, with no local recurrence observed at the 22-month mid-term follow-up.
• The patient experienced no major perioperative complications.

Implications:

• Multi-step, multi-specialty surgical intervention is a feasible and effective strategy for treating primary UPS in difficult anatomical locations.
• Close collaboration among surgical specialists and multidisciplinary tumor boards is crucial for developing personalized treatment plans for sarcoma patients.