Adiputra Putu Anda Tusta
Surgical Oncology Subdivision, Department of Surgery, School of Medicine, Udayana University-Sanglah General Hospital, Denpasar, Indonesia, Denpasar, Indonesia.
Case Rep Oncol. 2018 Mar 20;11(1):179-184. doi: 10.1159/000487476. eCollection 2018 Jan-Apr.
A 5-year-old girl presented with a big painless mass, sized 24 × 37 × 35 cm, in her lower left limb. MRI revealed a huge heterogeneous mass splaying from the left distal femur to the calcaneal region without bony erosion but compressing the arteries and causing bowing of the left tibia and fibula bones. The difficulty was to determine the best course of action taken which would either be limb salvation or amputation. Considering that only a few muscles could be saved, the author initially recommended amputation but still considered a limb-sparing procedure. After a double set-up examination in the operating room, the author ultimately decided to save the affected limb. The salvaged limb was found to be viable after the surgery, and there was no further recurrence over a subsequent 6-month follow-up period. The careful surgical decision is vital in giving the best possible care to the patient.
一名5岁女孩左下肢出现一个大小为24×37×35厘米的无痛性大肿块。磁共振成像(MRI)显示一个巨大的异质性肿块,从左股骨远端延伸至跟骨区域,无骨质侵蚀,但压迫动脉并导致左胫骨和腓骨弯曲。难点在于确定最佳治疗方案,即保肢还是截肢。考虑到仅能保留少数肌肉,作者最初建议截肢,但仍考虑保肢手术。在手术室进行双重检查后,作者最终决定保留患肢。术后发现保留的肢体存活,在随后6个月的随访期内未出现进一步复发。谨慎的手术决策对于为患者提供尽可能最佳的治疗至关重要。