Saving the Limb, Defying Recurrence: Vascular Reconstruction in Recurrent Osteosarcoma – A Case Report
DOI:
https://doi.org/10.31305/rrijm.2026.v11.n08.014Keywords:
bone tumor, chemotherapy, echocardiography, hemodynamics, limbAbstract
Background: Recurrent osteosarcoma of the lower limb presents a major surgical challenge, often requiring a balance between oncological clearance and preservation of limb function. Limb salvage with vascular reconstruction has emerged as a viable alternative to amputation in selected cases. Case Presentation: A 67-year-old female with a history of dedifferentiated adamantinoma of the right leg, previously treated with wide local excision and chemotherapy, presented with swelling in the mid-third of the leg. PET-CT showed increased metabolic activity, and biopsy confirmed recurrence as a high-grade sarcoma. MRI revealed a localized lesion in the mid-tibia. Management and Outcomes: The patient underwent limb salvage surgery with wide local excision and vascular reconstruction using a saphenous vein graft. A right anterior tibial–posterior tibial bypass with reversed great saphenous vein, along with thrombectomy and revision bypass, was performed. Soft tissue coverage was achieved using a gastrocnemius flap. Postoperative recovery was uneventful with good wound healing, adequate distal perfusion, and preserved limb function. Conclusion: Limb salvage with vascular reconstruction is a feasible and effective approach in selected cases of recurrent osteosarcoma, even with vascular involvement. Multidisciplinary management and meticulous surgical technique are key to successful outcomes.
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