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Case Reports
. 2023 Oct 2:17:1608.
doi: 10.3332/ecancer.2023.1608. eCollection 2023.

Paediatric fibrosarcoma treatment

Adrián Cano-Padilla  1 , Augusto Ramírez  2 , Paola Cervantes-Rivera  3 , Rosalba Bellido-Magaña  4 , Gilberto Flores-Vargas  5 , Nicolás Padilla-Raygoza  5
Affiliations
Case Reports

Paediatric fibrosarcoma treatment

Adrián Cano-Padilla et al. Ecancermedicalscience. .

Abstract

Introduction: Soft tissue sarcomas make up 7%-15% of childhood solid tumours. The aetiology of this disease is unknown. It is a fast-growing, painless tumour; histologically similar to adult fibrosarcoma, but having a lesser risk of metastasis and a better prognosis. The treatment is aimed towards localised intervention; complete surgical resection is the appropriate treatment as long as it can be performed.

Case report: An 11 years old female was referred for resection of a soft tissue tumour on the right elbow with significant peripheral vascularisation. Tumour resection was scheduled, with the placement of a partial thickness skin graft, and a piece was sent to pathology; a histological type consistent with paediatric fibrosarcoma was obtained with margins less than 1 mm from the lesion. Therefore, the patient was referred to the paediatric oncology unit. Further studies with positron emission tomography were requested, in which no evidence of macroscopic anatomy-metabolic tumour activity was found. Subsequently, treatment was started by paediatric oncology with 2 sessions of chemotherapy and 20 sessions of radiotherapy with sufficient progress; finally, assessment by plastic and reconstructive surgery was performed and an adequate quality of graft was observed, without the need for any other intervention by their service.

Conclusion: The involvement of the vascular surgeon in performing the tumour resection permitted the preservation of the best circulation to the extremity, thereby, avoiding amputation. The difficult decision made by the reconstructive surgeon to place a partial thickness graft over the surgical site, and to start radiotherapy/chemotherapy by paediatric oncology, were key to the success in achieving the patient's satisfactory progress.

Keywords: children; fibrosarcoma; soft tissue; surgery.

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Conflict of interest statement

The authors declare that they have no conflicts of interest.

Figures

Figure 1.
Figure 1.. Tumefaction on the right elbow. 10 × 15 cm right elbow tumour before surgical intervention. Source: Clinical record.
Figure 2.
Figure 2.. NMR of the right elbow. Source: Clinical record.
Figure 3.
Figure 3.. Excision of tumour on right elbow. Source: Clinical record.
Figure 4.
Figure 4.. Partial thickness graft on the right elbow. Source: Clinical record.
Figure 5.
Figure 5.. Coronal PET CT. Source: Clinical record.
Figure 6.
Figure 6.. Sagittal PET CT. Source: Clinical record.
Figure 7.
Figure 7.. Skin graft examination. Source: Clinical record.
See this image and copyright information in PMC

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