Skip to main content

Sarcoma of Extremities Presenting as Ulceration

Abstract

Sarcomas are relative rare malignant tumors arising from the mesenchymal tissue, which encompasses muscles, fat, bone, blood vessels, and fibrous or other supporting tissue [1]. An ulcer is a local defect or excavation of the surface of an organ or tissue characterized by a “full-thickness depth,” which implies that there are no sources for reepithelialization left in the center of the ulcer, and a “slow healing tendency” [2].

Keywords

  • Soft Tissue Sarcoma
  • Malignant Bone Tumor
  • Bone Sarcoma
  • Venous Insufficiency
  • Epithelioid Sarcoma

These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

This is a preview of subscription content, access via your institution.

Buying options

Chapter
USD   29.95
Price excludes VAT (USA)
  • DOI: 10.1007/978-81-322-2635-2_25
  • Chapter length: 14 pages
  • Instant PDF download
  • Readable on all devices
  • Own it forever
  • Exclusive offer for individuals only
  • Tax calculation will be finalised during checkout
eBook
USD   84.99
Price excludes VAT (USA)
  • ISBN: 978-81-322-2635-2
  • Instant PDF download
  • Readable on all devices
  • Own it forever
  • Exclusive offer for individuals only
  • Tax calculation will be finalised during checkout
Softcover Book
USD   109.99
Price excludes VAT (USA)
Hardcover Book
USD   159.99
Price excludes VAT (USA)
Fig. 25.1
Fig. 25.2

References

  1. Perisano C, et al. Misdiagnosis of soft tissue sarcomas of the lower limb associated with deep venous thrombosis: report of two cases and review of the literature. BMC Musculoskelet Disord. 2013;14:64.

    CrossRef  PubMed  PubMed Central  Google Scholar 

  2. Baker SR, et al. Epidemiology of chronic venous ulcers. Br J Surg. 1991;78:864–7.

    CAS  CrossRef  PubMed  Google Scholar 

  3. Ilaslan H, et al. Clinical presentation and imaging of bone and soft-tissue sarcomas. Cleve Clin J Med. 2010;77 Suppl 1:S2–7.

    CrossRef  PubMed  Google Scholar 

  4. What is sarcoma? http://www.sarcoma.org.uk/what-is-sarcoma

  5. Simon MA, Springfield D. Surgery for Bone and Soft-Tissue Tumors. Philadelphia, PA: Lippincott-Raven; 1998. p. 198–200.

    Google Scholar 

  6. Burningham Z et al. The epidemiology of sarcoma. Clin Sarcoma Res. 2012. doi: 10.1186/2045-3329-2-14.

    Google Scholar 

  7. SEER*Stat Database: incidence – SEER 9 regs research Data, Nov 2010 Sub (1973–2008) < Katrina/Rita Population Adjustment > − Linked To County Attributes – Total U.S., 1969–2009 Counties, National Cancer Institute, DCCPS, Surveillance Research Program, Cancer Statistics Branch, released April 2011, based on the November 2010 submission. Surveillance, Epidemiology, and End Results (SEER) Program (http://www.seer.cancer.gov)

  8. Howlader N, Noone AM, Krapcho M, Neyman N, Aminou R, Waldron W, Altekruse SF, Kosary CL, Ruhl J, Tatalovich Z, Cho H, Mariotto A, Eisner MP, Lewis DR, Chen HS, Feuer EJ, Cronin KA, Edwards BK, editors. SEER cancer statistics review, 1975–2008. National Cancer Institute. Bethesda; http://seer.cancer.gov/csr/1975_2008/, based on November 2010 SEER data submission, posted to the SEER web site. 2011.

  9. Perisano C, et al. Soft tissue metastases in lung cancer: a review of the literature. Eur Rev Med Pharmacol Sci. 2012;16(14):1908–14.

    CAS  PubMed  Google Scholar 

  10. Lookingbill DP, et al. Skin involvement as the presenting sign of internal carcinoma. J Am Acad Dermatol. 1990;22:19–26.

    CAS  CrossRef  PubMed  Google Scholar 

  11. Ryan TJ. The epidemiology of leg ulcers. In: Westerhof W, editor. Leg Ulcers: Diagnosis and Treatment. Amsterdam: Elsevier Science Publishers BV; 1993.

    Google Scholar 

  12. Dowsett C. Malignant fungating wounds: assessment and management. Br J Nurs. 2002;7:394–400.

    CrossRef  Google Scholar 

  13. Clark J. Metronidazole gel in managing malodorous fungating wounds. Br J Nurs. 2002;11(6 Suppl):S54e–60.

    CrossRef  Google Scholar 

  14. Probst S, et al. Malignant fungating wounds: a survey of nurses’ clinical practice in Switzerland. Eur J Oncol Nurs. 2009;13:295–8.

    CrossRef  PubMed  Google Scholar 

  15. Haisfield-Wolfe ME, Rund C. Malignant cutaneous wounds: a management protocol. Ostomy Wound Manage. 1997;43(1):56–60.

    CAS  PubMed  Google Scholar 

  16. Mekkes JR, et al. Causes, investigation and treatment of leg ulceration. Br J Dermatol. 2003;148:388–401.

    CAS  CrossRef  PubMed  Google Scholar 

  17. Khan AF, et al. Prevalence and presentation of chronic venous disease in Pakistan: a multicentre study. Phlebology. 2013. doi:10.1258/phleb.2012.011122.

    PubMed  Google Scholar 

  18. Shmookler B et al. Bone and soft-tissue sarcomas: epidemiology, radiology, pathology and fundamentals of surgical treatment. Musculoskeletal cancer surgery. 2001. p. 3–35. doi: 10.1007/0-306-48407-2_1

  19. Schwartz RA. Cutaneous metastatic disease. J Am Acad Dermatol. 1995;33:161–82.

    CAS  CrossRef  PubMed  Google Scholar 

  20. Collier M. The assessment of patients with malignant fungating wounds – a holistic approach: part 1. Nurs Times. 1997;93(suppl):1–4.

    Google Scholar 

  21. Grocott P, Cowley S. The palliative management of fungating malignant wounds – generalising from multiple case study data using a system of reasoning. Int J Nurs Stud. 2001;38:533–45.

    CAS  CrossRef  PubMed  Google Scholar 

  22. Naylor W. Assessment and management of pain in fungating wounds. Br J Nurs. 2001;10 Suppl 22:S33–6.

    CAS  CrossRef  PubMed  Google Scholar 

  23. Eary JF, Conrad EU. Imaging in sarcoma. J Nucl Med. 2011. doi:10.2967/jnumed.111.092999.

    PubMed Central  Google Scholar 

  24. White LM, Buckwalter KA. Technical considerations: CT and MR imaging in the postoperative orthopedic patient. Semin Musculoskelet Radiol. 2002;6:5–17.

    CrossRef  PubMed  Google Scholar 

  25. Wu JS, Hochman MG. Soft-tissue tumors and tumorlike lesions: a systematic imaging approach. Radiology. 2009;253:297–316.

    CrossRef  PubMed  Google Scholar 

  26. Chan WP. Magnetic resonance imaging of soft-tissue tumors of the extremities: a practical approach. World J Radiol. 2013;5(12):455–9.

    CrossRef  PubMed  PubMed Central  Google Scholar 

  27. Blodgett TM, et al. Issues, controversies, and clinical utility of combined PET/CT imaging: what is the interpreting physician facing? AJR Am J Roentgenol. 2005;184 Suppl 5:S138–45.

    CrossRef  PubMed  Google Scholar 

  28. Grocott P. The management of fungating wounds. J Wound Care. 1999;8:232–4.

    CAS  CrossRef  PubMed  Google Scholar 

  29. Maida V. Wound management in patients with advanced illness. Curr Opin Support Palliative Care. 2013. doi:10.1097/SPC0b013e32835c48e5.

    Google Scholar 

  30. Ferris FD, et al. Palliative wound care: managing chronic wounds across life’s continuum: a consensus statement from the International Palliative Wound Care Initiative. J Palliat Med. 2007;10:37–9.

    CrossRef  PubMed  Google Scholar 

  31. Meaume S, et al. Neoplastic wounds and degenerescence. J Tissue Viability. 2013. doi:10.1016/j.jtv.2013.07.001.

    PubMed  Google Scholar 

  32. Wafa H, Grimer RJ. Surgical options and outcomes in bone sarcoma. Expert Rev Anticancer Ther. 2006;6(2):239–48.

    CrossRef  PubMed  Google Scholar 

  33. Gaston CL, et al. Is limb salvage surgery safe for bone sarcomas identified after a previous surgical procedure? Bone Joint J. 2014;96-B(5):665–72.

    CAS  CrossRef  PubMed  Google Scholar 

  34. Papagelopoulos PJ, et al. Current concepts for management of soft tissue sarcomas of the extremities. J Surg Orthop Adv. 2008;17:204–15.

    PubMed  Google Scholar 

  35. Daigeler A, et al. Proximal major limb amputations: a retrospective analysis of 45 oncological cases. World J Surg Oncol. 2009;7:15.

    CrossRef  PubMed  PubMed Central  Google Scholar 

  36. Dion N, Sim FH. The use of allografts in musculoskeletal oncology. Instr Course Lect. 2002;51:499–506.

    PubMed  Google Scholar 

  37. Capanna R, et al. A new technique for reconstructions of large metadiaphyseal bone defects: a combined graft (allograft shell plus vascularized fibula). Orthop Traumatol. 1993;2:159–77.

    CrossRef  Google Scholar 

  38. Scoccianti G, et al. The use of osteo-articular allografts for reconstruction after resection of the distal radius for tumour. J Bone Joint Surg Br. 2010;92(12):1690–4.

    CAS  CrossRef  PubMed  Google Scholar 

  39. Chang DW, Robb GL. Recent advances in reconstructive surgery for soft-tissue sarcomas. Curr Oncol Rep. 2000;2:495–501.

    CAS  CrossRef  PubMed  Google Scholar 

  40. Chen CM, et al. Reconstruction of extremity long bone defects after sarcoma resection with vascularized fibula flaps: a 10-year review. Plast Reconstr Surg. 2007;119:915–24.

    CAS  CrossRef  PubMed  Google Scholar 

  41. Kadam D. Limb salvage surgery. Indian J Plast Surg. 2013;46(2):265–74.

    CrossRef  PubMed  PubMed Central  Google Scholar 

  42. Saint-Cyr M, et al. Free tissue transfers and replantation. Plast Reconstruct Surg. 2012;130:858e.

    CAS  CrossRef  Google Scholar 

  43. Choudry UH, et al. The vascularized medial femoral condyle periosteal bone flap for the treatment of recalcitrant bony nonunions. Ann Plast Surg. 2008;60(2):174–80.

    CAS  CrossRef  PubMed  Google Scholar 

  44. BC Cancer Agency. Malignant wound care guidelines. 2001; http://ww.bccancer.bc.ca.

  45. Barton P, Parslow N. Caring for oncology wounds- management guidelines. 1998. http://www.worldwidewounds.com.

  46. Cartwright A. Nutritional assessment as part of wound management. Nursing Times. 2002;98(44):62–3.

    PubMed  Google Scholar 

  47. Collier M. Management of patients with fungating wounds. Nurs Stand. 2000;15(11):46–52.

    CAS  CrossRef  PubMed  Google Scholar 

  48. “Care of malignant wounds” BCCA guidelines. 2004. http://www.bccancer.bc.ca/.

  49. Seaman S. Dressing selection in chronic wound management. J Am Podiatr Med Assoc. 2002;92:24–33.

    CrossRef  PubMed  Google Scholar 

  50. Ford-Dunn S. Use of vacuum assisted closure therapy in the palliation of a malignant wound. Palliat Med. 2006;20(4):477–8.

    CrossRef  PubMed  Google Scholar 

  51. Cihoric N, et al. Clinically significant bleeding in incurable cancer patients: effectiveness of hemostatic radiotherapy. Radiat Oncol. 2012;7:132.

    CrossRef  PubMed  PubMed Central  Google Scholar 

  52. Lund-Nielsen B, et al. Qualitative bacteriology in malignant wounds – a prospective, randomized, clinical study compare the effect of honey and silver dressing. Ostomy Wound Manage. 2011;57:28–36.

    PubMed  Google Scholar 

  53. Seaman S. Management of malignant fungating wounds in advanced cancer. Semin Oncol Nurs. 2006;22:185–93.

    CrossRef  PubMed  Google Scholar 

  54. Kerihuel JC. Effect of activated charcoal dressings on healing outcomes of chronic wounds. J Wound Care. 2010;19(208):210–2, 214–5.

    Google Scholar 

  55. Ashford RFU, et al. Metronidazole in smelly tumours. Lancet. 1980;1:874–5.

    CAS  CrossRef  PubMed  Google Scholar 

  56. Patterson DR, et al. Hypnotherapy as a treatment for pain in patients with burns: research and clinical considerations. J Burn Care Rehabil. 1987;8:263–8.

    CAS  CrossRef  PubMed  Google Scholar 

  57. Greengrass RA, Duclas Jr R. Paravertebral blocks. Int Anesth Clin. 2012;50:56–73.

    CrossRef  Google Scholar 

  58. Krajnik M, et al. Potential uses of topical opioids in palliative care – report of 6 cases. Pain. 1999;80:121–5.

    CAS  CrossRef  PubMed  Google Scholar 

  59. Flock P. Pilot study to determine the effectiveness of diamorphine gel to control pressure ulcer pain. J Pain Symptom Manage. 2003;25:547–54.

    CAS  CrossRef  PubMed  Google Scholar 

  60. Vernassier C, et al. Study to determine the efficacy of topical morphine on painful chronic skin ulcers. J Wound Care. 2005;14:289–93.

    CrossRef  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Carlo Perisano .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and Permissions

Copyright information

© 2016 Springer India

About this chapter

Cite this chapter

Perisano, C., Maccauro, G. (2016). Sarcoma of Extremities Presenting as Ulceration. In: Khanna, A., Tiwary, S. (eds) Ulcers of the Lower Extremity. Springer, New Delhi. https://doi.org/10.1007/978-81-322-2635-2_25

Download citation

  • DOI: https://doi.org/10.1007/978-81-322-2635-2_25

  • Published:

  • Publisher Name: Springer, New Delhi

  • Print ISBN: 978-81-322-2633-8

  • Online ISBN: 978-81-322-2635-2

  • eBook Packages: MedicineMedicine (R0)