Femoro-popliteal autogenous venous bypass in surgical treatment of soft tissue sarcomas of the lower limbs: clinical case

Abstract

Sarcomas are common among a rare and heterogeneous group of solid tumors of mesenchymal origin, accounting for only 1 % of all adult malignancies. Soft tissue sarcoma arises primarily from the embryonic mesoderm with some involvement of the neuroectoderm. The modern World Health Organization clinical and morphological classification includes more than 100 forms of these tumors. The diagnostic methods and treatment modalities of soft tissue sarcomas have evolved with the multidisciplinary approach. The standard treatment for localized phase sarcomas is local excision followed by radiotherapy, but since 2010 preoperative radiotherapy has been considered the preferred option (according to the recommendations of the National Comprehensive Cancer Network, NCCN). The use of vascular surgery and femoropopliteal autovenous grafting in surgical tactics allows performing radical operations with limb preservation. The article presents a clinical case of treatment of a patient with a diagnosis of soft tissue leiomyosarcoma of the right popliteal region. In the volume of combined treatment, the surgical intervention – removal of a soft tissue tumor low part of the right thigh and popliteal fossa with resection of the posterior thigh muscle group together with the involved popliteal artery, with simultaneous femoropopliteal autovenous prosthetics – was performed.