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CC BY-NC-ND 4.0 · Revista Chilena de Ortopedia y Traumatología 2021; 62(03): e221-e226
DOI: 10.1055/s-0041-1740233
Caso Clínico | Case Report

Primary Bone Leiomyosarcoma in the Distal Femur with Clavicle Metastasis. A Case Report

Artikel in mehreren Sprachen: español | English
Francisco Linares R
1   Especialista en Cirugía Ortopédica Oncológica, Hospital Universitario San Ignacio, Bogotá, Colombia
,
Helbert Martín V
2   Residente del IV año de Ortopedia y Traumatología, Hospital Universitario San Ignacio, Bogotá, Colombia
,
Natalia Correal A
3   Estudiante de XII semestre, Unidad de Ortopedia, Hospital Universitario San Ignacio, Bogotá, Colombia
› Institutsangaben Funding The present research has not received any specific grants from public, commercial, or non-profit sector agencies.
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Abstract

Leiomyosarcoma (LMS) is a type of spindle-cell tumor of very low incidence that tumor has an aggressive behavior, with high mortality rates; therefore, its management must be surgical, with a wide resection of the lesion. The role of radio and chemotherapy in its management is not clear. We present the case of a 28-year-old female patient who consulted for pain lasting 2 months in the right knee. Radiographically, it was characterized as a pure osteolytic lesion in the distal femur. Contrast magnetic resonance imaging (MRI) showed hypervascular areas within the tumor. The scintigraphy showed a marked increase in radiotracer uptake. A biopsy was taken, with a pathology report of well-differentiated osseous LMS. It was treated with 3 cycles of preoperative neoadjuvant chemotherapy with ifosfamide 1,000 mg/m2 in the first 3 days, as well as doxorubicin 70 mg/m2, and surgical resection of the lesion and limb salvage with knee endoprosthesis. Once the lesion was resected, the patient underwent adjuvant chemotherapy, with 4 cycles of gencitabine 1,000 mg/m2 between days 1 and 8, and doxetacel 70 mg/m2 on day 1. During the 2-month follow-up, the patient presented a fracture in the middle third of the clavicle, which was compatible with a pathological lesion on radiographs and positron-emission tomography (PET) scans. The biopsy showed a metastatic lesion of bone LMS, which was treated by surgical resection of the clavicle. This is a unique case, given that, during the follow-up, the patient underwent adjuvant treatment with chemotherapy, and was evaluated with a PET scan, with a satisfactory clinical evolution and no evidence of new lesions.

Level of evidence IV.

Keywords

bone tumor - leiomyosarcoma - bone metastasis


Publikationsverlauf

Eingereicht: 14. Mai 2020

Angenommen: 21. Januar 2021

Artikel online veröffentlicht:
22. Dezember 2021

© 2021. Sociedad Chilena de Ortopedia y Traumatologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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