Hong Kong Journal of Orthopaedic Surgery

Volume 5 Number 1, April 2001
Abstract

A lady with thigh mass: an uncommon pathology

Leung WY, Cheung MF1, Wu WC
Department of Orthopaedics and Traumatology and 1Department of Clinical Pathology, Pamela Youde Nethersole Eastern Hospital, Hong Kong.

We report on a 61-year-old woman who presented with a mass in her left thigh. Magnetic resonance imaging showed a heterogeneous mass surrounding the femoral neurovascular bundle and extending into the adductor and anterior and posterior compartments. Tumour biopsy revealed intermediated-grade leiomyosarcoma, for which high above-knee amputation was performed. Histological examination showed that tumour cells had infiltrated and completely occluded the femoral artery and vein, with intramural spread along the arterial wall beyond the confines of the tumour, and was close to the proximal vascular resection margin. Further excision of the tumour was suggested but was refused by the patient. Local radiotherapy was thus given instead. The patient showed no evidence of local recurrence or distant metastasis 3 years after surgery. The tumour probably had a vascular origin, most likely in the femoral artery. Vascular leiomyosarcoma is uncommon, and leiomyosarcoma of the arterial system in an extremity is even less common. (Hong Kong j. orthop. surg. 2001;5(1):74,90-93)

Key Words: Biopsy; Leiomyosarcoma/pathology; Vascular neoplasms/diagnosis; Middle age

生於一女士大腿之腫瘤:一種罕見疾病

梁偉揚、張文鳳、胡永祥

本文報導一位左大腿患有腫瘤的61歲女士的情況。磁共振成像顯示股骨周圍的神經血管束被異常組織包圉,並伸展至股內收及股前後區分。活體檢視測試證實為中級的惡性平滑肌肉瘤,並以膝部以上截肢手術治療。組織學測試顯示腫瘤細胞已滲入並完全閉塞股動靜脈壁伸延至截肢近端切口。術後建議病者再接受手術將可能殘留之腫瘤細胞割除,但被拒絕。後故以放射治療理切口部位。病者手術後3年並無腫瘤復發跡象。該腫瘤可能源於血管,尤其股動脈。源於血管的惡性平滑肌肉瘤並不常見;源於肢體的動脈則更為罕見。


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