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Hemipelvectomy with laparoscopic abdominoperineal excision for epithelioid sarcoma treatment Study conducted at Fundação Benjamin Guimarães, Hospital da Baleia, Departamento de Cirurgia Geral, Belo Horizonte, MG, Brazil.

Hemipelvectomia com amputação laparoscópica do reto para tratamento de sarcoma epitelioide

Abstract

The epithelioid sarcoma (ES) is an unusual variant of the sarcoma, not reaching 1% of all soft tissue sarcomas. Initially reported in 1970, it has a more aggressive variant, which was classified as the “proximal-type” in 1997. These are aggressive tumors with high rates of distant metastasis and local relapses. Isolated radio and chemotherapy responses are poor and free-margin surgical resection is the treatment of choice.This is the case report of a 25-year-old male patient diagnosed with “proximal-type” ES in the perineal region. He underwent surgical resection in another institution and was later admitted to our institution with local recurrence with rectal and left thigh muscle invasion. Neoadjuvant radio-chemotherapy was performed, followed by laparoscopic abdominoperineal rectal resection and partial left hemipelvectomy associated with left lower-limb amputation. The patient had no postoperative complications and is currently undergoing outpatient follow-up. The anatomopathological analysis showed tumor-free margins.The “proximal-type” ES is a rare soft-tissue sarcoma subtype. High local recurrence, as well as the metastasis rates, makes its treatment a challenging task.

Keywords
Sarcoma; Epithelioid sarcoma; Soft tissue sarcoma; Neoplasm

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