A Rare Case of Primary Sarcoma Arising Within Free Muscle Transfer

Area of Science:

• Oncology
• Orthopedic Surgery
• Plastic Surgery

Background:

• Soft tissue sarcomas are rare cancers.
• Reconstruction of open lower limb fractures often involves complex procedures like free latissimus dorsi (LD) muscle flaps.
• Long-term monitoring of such reconstructions is crucial for detecting rare complications.

Purpose of the Study:

• To report a unique case of rhabdomyosarcoma arising in a latissimus dorsi muscle flap.
• To highlight the potential for late-onset malignancy in reconstructed tissues.
• To discuss the management and outcomes of this rare presentation.

Main Methods:

• Case report of a 35-year-old male with a history of open lower limb fracture and LD flap reconstruction.
• Detailed description of the patient's complex postoperative course, including osteomyelitis and refracture.
• Histological confirmation of rhabdomyosarcoma within the LD flap.
• Surgical management involving transfemoral amputation and prosthetic rehabilitation.

Main Results:

• The patient developed rhabdomyosarcoma 11 years post-reconstruction.
• Histological analysis confirmed the diagnosis within the latissimus dorsi muscle flap.
• Transfemoral amputation was performed for definitive treatment.
• The patient achieved remission and is now pain-free with prosthesis use.

Conclusions:

• Latissimus dorsi muscle flaps, while valuable for reconstruction, can rarely develop malignancies years later.
• This case underscores the importance of long-term surveillance for patients with complex reconstructive histories.
• Early diagnosis and appropriate surgical intervention are critical for favorable outcomes in rare sarcoma cases.