Acta chirurgiae orthopaedicae
et traumatologiae Čechoslovaca

Acta Chir Orthop Traumatol Cech. 2023; 90(3):181-187 | DOI: 10.55095/achot2023/025

Popliteal Fossa SarcomasOriginal papers

O. ERDOGAN^1,*, A. ÇELİK², A. N. T. YILDIRIM³, E. TEKÇE⁴, G. ALTUN⁵, S. DEMİRÖZ⁶, Y. GÜLER⁸, K. OZKAN², V. GURKAN⁷

¹ Haydarpasa Numune Training and Research Hospital, Orthopaedics and Traumatology Clinic, Istanbul, Turkey

² Istanbul Medeniyet University, Faculty of Medicine, Orthopaedics and Traumatology Clinic, Istanbul, Turkey

³ Istanbul Medeniyet University, Faculty of Medicine, Pathology Clinic, Istanbul, Turkey

⁴ Bezmialem University, Faculty of Medicine, Radiation Oncology Clinic, Istanbul, Turkey

⁵ Ümraniye Training and Research Hospital, Orthopaedics and Traumatology Clinic, Istanbul, Turkey

⁶ Kocaeli University, Orthopaedics and Traumatology Clinic, Kocaeli, Turkey

⁷ Bezmialem University, Faculty of Medicine, Orthopaedics and Traumatology Clinic, Istanbul, Turkey

⁸ Baltalimanı Training and Research Hospital, Orthopaedics and Traumatology Clinic, Istanbul, Turkey

PURPOSE OF THE STUDY:
Soft tissue sarcomas of the popliteal fossa are extremely rare tumors of mesenchymal origin accounting for 3%-5% of all extremity sarcomas. However, data regarding the tumor type, neurovascular involvement, and administration of radiation therapy before or after resection are limited. This study aimed to report on popliteal fossa sarcomas analyzing data from two institutions based on a relatively large patient sample.

MATERIAL AND METHODS:
Twenty-four patients (80%; 9 men and 15 women) with a popliteal fossa soft tissue sarcoma were included in this study. The reviewed patient data included sex, age, duration of complaints, interval to diagnosis, radiology, pre- and postoperative biopsy, tumor histology, surgery type, complications, and pre- and postoperative oncologic and functional outcomes. The minimum follow-up was 24 months.

RESULTS:
The mean age of the patients was 48 ± 21.23 (range 3-72) years at the time of diagnosis. The mean follow-up was 41.79 ± 16.97 (range 24-120) months. The most common histological diagnoses were synovial sarcoma (6 patients), hemangiopericytoma (2 patients), soft tissue osteosarcoma (2 patients), unidentified fusiform cell sarcoma (2 patients), and myxofibrosarcoma (2 patients). Local recurrence after limb salvage was observed in six patients (26%). At the latest follow-up, 2 patients died of the disease, 2 patients were still alive with progressive lung disease and soft tissue metastasis, and the remaining 20 patients were free from the disease.

CONCLUSIONS:
Microscopically positive margins may not be an absolute indication for amputation. Also, negative margins do not provide a guarantee that local recurrence will not occur. Lymph node or distant metastasis may be predictive factors for local recurrence rather than positive margins.

Keywords: fossa poplitea, sarcoma

Published: June 22, 2023  Show citation