Why the study?
Neurovascular invasion in large synovial sarcomas complicates limb salvage and tumor-free margin achievement, and options for vascular reconstruction remain an open debate.
Does a limb-salvaging approach with vessel reconstruction improve outcomes in patients with synovial sarcoma with femoral vessel involvement?
Does a limb-salvaging approach with vessel reconstruction improve outcomes in patients with synovial sarcoma with femoral vessel involvement?
Limb-salvaging surgery with one-stage vessel reconstruction is a viable and effective option for synovial sarcoma with femoral vessel encasement, yielding good long-term functional and oncological outcomes.
Limb salvage with vascular reconstruction may be feasible in select cases; leaves open optimal patient selection and long-term outcomes.
Synovial sarcoma is a rare soft tissue sarcoma that often arises at a young age in the lower limbs. A large tumor size with neurovascular invasion leads to difficulties in salvaging the limb and achieving tumor-free margins during excision. Limb amputation used to be the only choice in such consideration. In addition, options for vascular reconstruction remain an open debate. Herein, we present a case of a large synovial sarcoma with the encasement of femoral vessels and the limb-salvaging approach, which employed wide excision with vessel reconstruction and their coverage in one stage. The patient recovered well with both satisfactorily aesthetic and functional outcomes at 5-year follow-up following postoperative concurrent chemoradiation therapy, and without any evidence of tumor recurrence.
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Hsieh et al. (2025) studied this question.
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