Limb salvage surgery in a rare case of Low-grade myofibroblastic sarcoma of femur following Oops Procedure

Abstract

Introduction: Low-grade myofibroblastic sarcoma (LMFS) is a rare spindle cell tumour with characteristic myofibroblasts showing features of both fibroblasts and smooth muscle cells. Primary LMFS of bone is extremely rare, and We are reporting one such case which presented to us following open biopsy and curettage from elsewhere. Case presentation: A 41 year old male patient presented with mildly expansile lesion of left shaft of femur with mild endosteal scalloping, following open biopsy, curettage and bone grafting from elsewhere. Post op HPE was s/o low grade myobroblastic sarcoma, slides were reviewed and the disease confirmed with immunohistochemistry. The patient underwent en bloc excision ​+ ​ECRT autograft ​+ ​plating. (Post operative period was uneventful, with early mobilization of the patient)Patient was mobilised early and there was no post-operative complications. Patient is having satisfactory functional outcome based on MSTS score till the last follow up, with no evidence of disease. Conclusion: Low-grade myofibroblastic sarcoma is a rare osseous neoplasm. A thorough radiological and pathological examination with immunohistochemical expression is mandatory for accurate diagnosis and to differentiate from its close differentials.

Keywords

• Low-grade myofibroblastic sarcoma
• Extracorporeal Radiotherapy (ECRT) autograft
• Immunohistochemical expression