Soft Tissue Sarcoma Resections

It is a procedure that involves removing a tumor (malignant or benign) of the soft tissues (muscle or fat) while preserving the surrounding healthy bone and soft tissues.

Soft Tissue Tumor 2

What is a Radical Resection of a Soft Tissue Sarcoma?

Soft-tissue tumors or soft-tissue sarcomas most commonly arise from the deep muscles of the extremity (limb). The thigh is the most common site, however, a soft-tissue sarcoma can really arise from any part of the body including any extremity including buttock, back, shoulder, arm, forearm, hands, feet, or calves. They generally present as a painless mass that has increased in size over some time period. They may cause pain in some cases. Occasionally, a patient may give a history of a previous trauma or injury to the area that really has nothing to do with development of the soft-tissue tumor. MRI imaging is used to view the soft-tissue tumor, but a biopsy may be warranted if there is uncertainty or suspicion of malignancy (cancerous) in order to obtain a definitive diagnosis. Some of the most common benign soft tissue tumors include lipomas, schwannomas, and hemangioma. Likewise, undifferentiated pleomorphic sarcoma, angiosarcoma, and liposarcoma are some of the more common malignant (cancerous) soft tissue tumors. If the tumor is malignant and typically responds well to chemotherapy or radiation, then these adjuvant (additional) therapies may be utilized during the course of treatment. Pre-operative or postoperative radiation is often combined with surgical removal. The radiation gets rid of any microscopic cells that may re-grow and reduces the risk of the tumor coming back or recurring. Some soft tissue masses may be more difficult to remove than others depending on anatomical location, size, and involvement with surrounding major arteries, veins, or nerves. However, approximately 95% of soft tissue tumors can be removed while preserving the affected limb. In some instances the extremity cannot be saved and an amputation is performed. Contraindications for saving the limb may include neurovascular invasion, infection, pathological fracture, extensive disease, contamination from a poorly performed biopsy, recurrent disease.  

Quads Tumor Removal



What’s involved in the technique?

What you can expect afterwards

After your surgery you may spend a few nights in the hospital depending on the type of surgery. Once discharged from the hospital, you will be recuperating at home. Various pain protocols and nerve blocks may be used to minimize pain. Mostly all patients are very comfortable after the surgery. For the first few days you will ice the area and keep it elevated to reduce swelling. Dr. Wittig usually wants you to keep the same bandages in place that were put on in the OR in a sterile manner and keep the site dry until you return to the office. You will usually return to the office 2 weeks after surgery. Once cleared, you will subsequently start physical therapy. We usually prescribe specific physical therapy protocols 3 times a week for 12 weeks after surgery to gradually strengthen muscles. Strengthening  commences with significant resistance after sufficient range of motion is achieved as determined by Dr. Wittig. There may be an ultimate weight limit imposed upon you depending on various factors.  

You will be monitored periodically with MRI imaging over the course of 5 years to ensure there are no signs of recurrence. You will also likely be monitored for metastases with a CT scan of the chest, abdomen and pelvis. You may, depending on size and grade of the sarcoma, have follow up appointments every 4 months for the first 2 years, then every 6 months for the next 2 years, and then once a year often up to year 10. For the best results, physical therapy protocols should be followed strictly. After radiation and a large surgery, some degree of swelling can be anticipated that could last a lifetime. A proper diet and weight control are imperative to optimize recovery and the ultimate functional result.

Types Of Physical Therapy

Soft Tissue Sarcoma Removal Video

Dr. James Wittig narrates a video illustrating the surgical technique for resection of a soft tissue sarcoma. | WATCH VIDEO