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. 2022 Aug:97:107475.
doi: 10.1016/j.ijscr.2022.107475. Epub 2022 Aug 2.

Case series of high-grade soft tissue sarcoma of the lower limb with delayed diagnosis: Experience at a tertiary hospital in northern Tanzania

Jay Lodhia  1 , Gregory Goodluck  2 , Joylene Tendai  2 , Ellyagape Urassa  2 , Gilbert Nkya  3 , Alex Mremi  3
Affiliations

Case series of high-grade soft tissue sarcoma of the lower limb with delayed diagnosis: Experience at a tertiary hospital in northern Tanzania

Jay Lodhia et al. Int J Surg Case Rep. 2022 Aug.

Abstract

Introduction and importance: Soft tissue sarcoma is an uncommon form of cancer with poor prognosis. Early diagnosis and treatment are vital for improving the treatment outcomes.

Case presentation: We report a series of high-grade soft tissue sarcomas of the lower extremity with delayed diagnosis to gain insight into the presentation, treatments and outcomes for this rare disease and to determine whether limb-salvage surgery yields reasonable outcomes.

Clinical discussion: Timely health seeking has an impact on the outcome of the treatment of any particular disease. Patient delays are usually socio-economic factors. Soft tissues sarcomas are uncommon malignant tumors that even managed adequately have a poor 5-year survival. Limb salvage becomes questionable especially when patients present late with adverse symptoms.

Conclusion: In this series, we found that patients presented late and this led to unfavorable oncological outcomes, also limb salvage was not an option due to delayed presentation. Thus, early diagnosis is recommended so as to improve treatment outcome.

Keywords: Case series; Delayed presentation; Limb salvage; Soft tissue sarcoma; Tanzania.

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Conflict of interest statement

Authors declare no conflict of interests.

Figures

Fig. 1
Fig. 1
A. X-ray of left tibia and fibula showing proximal boney destruction with cortical reaction and soft tissue mass. B. Post transfemoral amputation showing large exophytic mass over the proximal leg. C. Histopathology of the tumor highlighting diffuse proliferation of large pleomorphic cells ovoid cell with frequent mitoses including bizarre ones; H&E stained sections 100× original magnifications. D. Immunopositivity of the tumor cells with Vimetin 40× original magnification.
Fig. 2
Fig. 2
A. Diffuse proliferation of large pleomorphic cells with rhaboid differentiation; H&E stained sections 200× original magnification. B. Immunopositivity of the tumor with MyoD1 60× Original magnification. C. X-ray of the femur showed distal femoral cortical thickening with soft tissue mass. D. CT-scan showing cortical erosion of the posterior aspect of distal femur and areas of soft tissue calcifications. E. Photograph showing post transfemoral amputation; lesion on the posterior aspect of distal femur.
Fig. 3
Fig. 3
A. Large cauli-flower like mass over left knee. B. Distal femur X-ray with soft tissue mass with no boney involvement. C. Photomicroscopy of the tumor highlighting diffuse tumor made up spindle shaped cells with storiform pattern; H&E 40× original magnification.
See this image and copyright information in PMC

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