Hong Kong Journal of Orthopaedic Surgery

Volume 5 Number 1, April 2001

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




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