Operative Management of Soft Tissue Sarcomas Adherent to Major Vessels

Eleven cases of soft tissue sarcomas arising in the thigh, particularly in the frontal or popliteal area, were estimated to be adherent to major large vessels by angiogram, CT, and/or MRI. Eight cases were tightly adherent to femoral vessels, and two to popliteal ones. Of these cases, seven underwent combined resection of tumor and affected vessels, followed by reconstruction with artificial vessels in five, and autogeneous saphenous vein graft in one. One case with femoral vein resection had no reconstruction.The popliteal fossa and femoral triangles are anatomicd spaces, but it is not feasible to resect large tumors safely or curatively without combined resection of these vessels. Therefore, in these areas, we recommend combined resection fo tumor and major vessels as the preferred management, at least in high grade lesions.