Key result
R1 resection plus postoperative radiotherapy achieves 18-month local control and preserves knee function in myxoid liposarcoma.
Why the study?
Myxoid liposarcoma rarely arises in the popliteal fossa, and managing giant, neurovascular-abutting lesions in young adults is poorly characterized.
Does function-preserving R1 resection plus postoperative radiotherapy prevent local recurrence and maintain limb function in a young patient with popliteal myxoid liposarcoma?
Case Report (n=1)
Does function-preserving R1 resection plus postoperative radiotherapy prevent local recurrence and maintain limb function in a young patient with popliteal myxoid liposarcoma?
Function-preserving R1 resection combined with postoperative radiotherapy can achieve local control and maintain limb function in young patients with popliteal myxoid liposarcoma abutting neurovascular structures.
Answers are grounded in this paper and cite their sources.
May support function-preserving R1 resection plus radiotherapy in select popliteal cases; hypothesis-generating from Level 5 evidence alone.
Rationale: Myxoid liposarcoma (MLS) accounts for 30% of liposarcomas and typically arises in the thigh, but rarely arises in the popliteal fossa. Managing giant, neurovascular-abutting MLS in young adults is poorly characterized. Patient concerns: A 35-year-old man presented with a right popliteal mass growing over > 6 years, accompanied by progressive swelling and incomplete flexion of the right knee. He denied smoking, denied alcohol use, and had no family history of malignancy. Diagnoses: magnetic resonance imaging showed a 179 × 154 × 99 mm multilocular cystic–solid lesion abutting/partly encasing the popliteal vessels and contacting the sciatic/common peroneal nerves. Preoperative cytology suggested benignity; definitive resection revealed MLS grade II with 20% round cell component (R1 margin adjacent to the vessel plane). Interventions: En bloc resection with function-preserving R1 margins was performed given neurovascular involvement; popliteal artery/vein and nerves were preserved. Postoperative external-beam radiotherapy was delivered to 60 Gy in 30 fractions (2 Gy/fraction). Outcomes: At the 18-month follow-up, progressive recovery of knee joint range of motion was observed, and no local recurrence or metastasis at 18 months. Magnetic resonance imaging at 6 and 18 months showed no local-recurrence or metastasis. Lessons: This case demonstrates that in young patients with popliteal MLS closely related to neurovascular structures, function-preserving R1 resection plus postoperative 60 Gy can achieve local-control while maintaining limb function, provided meticulous technique and guideline-concordant surveillance.
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Xu et al. (2026) conducted a case report in Myxoid liposarcoma of the right popliteal fossa (n=1). En bloc resection with function-preserving R1 margins and postoperative external-beam radiotherapy was evaluated on Local recurrence or metastasis. Function-preserving R1 resection plus postoperative 60 Gy radiotherapy achieved local control with no recurrence or metastasis at 18 months in a patient with popliteal myxoid liposarcoma.
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