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Case Reports
. 2024 Dec 7;16(12):e75303.
doi: 10.7759/cureus.75303. eCollection 2024 Dec.

Treatment of Distal Femoral Malignant Mesenchymal Tumor With Extensor Mechanism Transfer: A Case Report and Surgical Technique

Arın Celayir  1 , Burak Ozturk  1 , Şeyhmus Kavak  1 , Mahmut K Ozsahin  1 , Huseyin Botanlioglu  1
Affiliations
Case Reports

Treatment of Distal Femoral Malignant Mesenchymal Tumor With Extensor Mechanism Transfer: A Case Report and Surgical Technique

Arın Celayir et al. Cureus. .

Abstract

Malignant mesenchymal tumors are a diverse group of aggressive cancers originating from mesenchymal cells in connective tissues such as bone, muscle, cartilage, and fat. These tumors often invade surrounding tissues and metastasize to distant organs, posing significant treatment challenges. Among them, malignant mesenchymal tumors located in the distal femur are particularly rare, with limited reports detailing effective surgical and functional reconstruction strategies following wide resection. This case report focuses on the treatment of a distal femoral malignant mesenchymal tumor managed at our clinic, where wide resection was followed by reconstruction using a tumor resection prosthesis and extensor mechanism transfer. The report highlights the innovative surgical technique employed to restore extensor function while maintaining structural integrity, addressing a critical gap in the literature. By sharing insights into this approach, this report aims to contribute to the growing body of knowledge on limb salvage surgery and improve outcomes for patients with similar complex conditions.

Keywords: extensor mechanism transfer; gracilis; malignant mesenchymal tumor; medial parapatellar approach; wide resection.

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Conflict of interest statement

Human subjects: Consent for treatment and open access publication was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

Figures

Figure 1
Figure 1. X- ray images of the patient at the time of hospital admission.
(A) Left knee anterior-posterior view. (B) Left knee lateral view.
Figure 2
Figure 2. Magnetic resonance images of the patient.
(A-B-C) Coronal views of the patient.
Figure 3
Figure 3. Magnetic resonance images of the patient.
(A-B) Sagittal views of the patient.
Figure 4
Figure 4. Magnetic resonance images of the patient.
(A-B) Coronal views of the patient showing no skip metastasis.
Figure 5
Figure 5. Peroperative images of the patient.
(A) Before the surgery. (B) Longitudinal view of the lesion before removal. (C) Side view of the lesion before removal.
Figure 6
Figure 6. Peroperative images of the patient.
(A) Lesion after removal. (B) The remaining tissues after removal.
Figure 7
Figure 7. Peroperative images of the patient during the extensor mechanism reconstruction using sartorius and gracilis.
(A) Anterior view of the prosthesis before the reconstruction. (B-C) View of the prosthesis after the gracilis and sartorius reconstruction.
Figure 8
Figure 8. Postoperative X-ray images of the patient.
(A-B) Anterior-posterior views of the left knee and femur respectively. (C-D) Lateral views of the left knee and femur respectively.
See this image and copyright information in PMC

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