AI Article Synopsis
- Large unresectable soft tissue sarcomas (STS) present significant challenges for treatment, as traditional neoadjuvant therapies like chemotherapy and radiotherapy often lead to unsatisfactory results.
- A case report showcases the successful use of isolated limb perfusion (ILP) with TNF-alfa and Alkeran (Melphalan) in a patient with large myxoid liposarcoma, resulting in a 55% tumor size reduction and 99% tumor necrosis after surgery.
- The patient maintained full function of the limb and remained disease-free one year later, suggesting ILP could be a viable limb-sparing treatment option for select cases.
Article Abstract
Large unresectable STS presents a therapeutic challenge. Several options are being explored to avoid amputation without compromising the oncological outcome. Neoadjuvant chemotherapy delivers inconsistent and rather unsatisfactory results, preoperative radiotherapy compromises healing, hence it can impede adjuvant systemic treatment. We present a case report of neoadjuvant use of isolated limb perfusion with TNF-alfa and Alkeran (Melphalan) in a patient with initially unresectable large myxoid liposarcoma of the thigh. We achieved 55% reduction in size of the tumor that allowed for wide resection with a safe margin. Pathology confirmed 99% tumor necrosis. The patient has a full function of his extremity and is disease-free at one year follow-up. ILP should be considered as a treatment option which, in selected cases, can contribute to limb sparing surgery. Key words: sarcoma, soft tissue, regional perfusion, chemotherapy, surgery, orthopedic, limb salvage.
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