An interesting case of spindle cell sarcoma of elbow

Authors

  • Sana Aboosalih Department of General Surgery, Saveetha Medical College and Research Institute, Thandalam, Kanchipuram, Tamilnadu, India
  • V. Shruthi Kamal Department of General Surgery, Saveetha Medical College and Research Institute, Thandalam, Kanchipuram, Tamilnadu, India
  • Surya Rao Rao Venkata Mahipathy Department of Plastic and Reconstructive Surgery, Saveetha Medical College and Research Institute, Thandalam, Kanchipuram, Tamilnadu, India
  • Senthil Kumar Azhisoor Chandrasekhar Department of Surgical Oncology, Saveetha Medical College and Research Institute, Thandalam, Kanchipuram, Tamilnadu, India
  • Balu Krishnamurthy Mahendra Department of Surgical Oncology, Saveetha Medical College and Research Institute, Thandalam, Kanchipuram, Tamilnadu, India
  • Anand Prasath Jayachandiran Department of Plastic and Reconstructive Surgery, Saveetha Medical College and Research Institute, Thandalam, Kanchipuram, Tamilnadu, India
  • Narayanamurthy Sundaramurthy Department of Plastic and Reconstructive Surgery, Saveetha Medical College and Research Institute, Thandalam, Kanchipuram, Tamilnadu, India

DOI:

https://doi.org/10.18203/2349-2902.isj20203278

Keywords:

Spindle cell sarcoma, Ulnar nerve, Neuroanastomosis, End to side supercharge

Abstract

Spindle cell sarcomas are a group of aggressive malignant soft tissue tumors with a diverse clinical presentation. A 32 years old woman presented with a recurrent nerve sheath tumour, involving flexor carpi ulnaris and a portion of ulnar nerve. Wide local excision of the tumour was done creating a 4 cm gap defect in the ulnar nerve. Distal nerve transfer and Guyon’s canal release was done and anterior transposition of ulnar nerve to distal motor branch of ulnar nerve end to side (ETS) supercharge was done preserving motor function to the little and ring finger. Achieving negative surgical margins in primary soft tissue sarcoma is a critical for local disease control. The anatomical and functional compromise that can occur while giving adequate clearance margin for the tumor can be overcome by microsurgical techniques and neuroanastomosis with positive outcomes like preservation of function and better prognosis.

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Author Biographies

Sana Aboosalih, Department of General Surgery, Saveetha Medical College and Research Institute, Thandalam, Kanchipuram, Tamilnadu, India

Department of General Surgery, Resident.

V. Shruthi Kamal, Department of General Surgery, Saveetha Medical College and Research Institute, Thandalam, Kanchipuram, Tamilnadu, India

Professor & Head, Dept. of General Surgery

Surya Rao Rao Venkata Mahipathy, Department of Plastic and Reconstructive Surgery, Saveetha Medical College and Research Institute, Thandalam, Kanchipuram, Tamilnadu, India

Professor & Head, Dept. of Plastic & Reconstructive Surgery

Senthil Kumar Azhisoor Chandrasekhar, Department of Surgical Oncology, Saveetha Medical College and Research Institute, Thandalam, Kanchipuram, Tamilnadu, India

Associate Professor, Dept. of Surgical Oncology

Balu Krishnamurthy Mahendra, Department of Surgical Oncology, Saveetha Medical College and Research Institute, Thandalam, Kanchipuram, Tamilnadu, India

Assistant Professor, Dept. of Surgical Oncology

Anand Prasath Jayachandiran, Department of Plastic and Reconstructive Surgery, Saveetha Medical College and Research Institute, Thandalam, Kanchipuram, Tamilnadu, India

Assistant Professor, Dept. of Plastic & Reconstructive Surgery

Narayanamurthy Sundaramurthy, Department of Plastic and Reconstructive Surgery, Saveetha Medical College and Research Institute, Thandalam, Kanchipuram, Tamilnadu, India

Associate Professor, Dept. of Plastic & Reconstructive Surgery

References

Shankar V. Malignant peripheral nerve sheath tumor (MPNST). Pathology Outlines.com website. Available at http://www.pathologyoutlines.com/topic/softtissuempnst.html. Accessed on 9 February 2020.

Wikivet. Spindle Cell Tumours. Available at https://en.wikivet.net/Spindle_ Cell Tumours.

Akerman M, Domanski HA. Monographs in Clinical Cytology: The Cytology of Soft Tissue Tumours. Basel Karger. 2003;16:103-6.

Shaikh, Sohail, Katke, Rajshree, Raut, Soham. Spindle Cell Sarcoma Arising from Nerve Sheath Presenting as Huge Abdominal Mass. J Case Reports. 2014;4:232-5.

Stark AM, Buhl R, Hugo HH, Mehdorn HM. Malignant Peripheral Nerve Sheath Tumours - Report of 8 Cases and Review of the Literature. Acta Neurochirurgica. 2001;143(4):357-64.

Prakash N, Kumar HMS, Sharada P, Pradeep GL. Spindle Cell Carcinoma of the Oral Cavity: A Case Report of a Rare Entity and Review of Literature. World J Dentistry. 2010;1(1):55-8.

Shamim T. The spindle cell neoplasms of the oral cavity. Iran J Pathol. 2015;10(3):175-84.

Arpornchayanon O. Malignant Peripheral Nerve Tumors: A Clinicopathological and Electron Microscopic Study. Japanese J Clin Oncology. 1984;14(1):57-74.

Coady MSE, Polacarz S. Cutaneous Malignant Peripheral Nerve Sheath Tumour (MPNST) of the Hand: A Review of Current Literature. J Hand Surg. 1993;18(4):478-81.

Dunn JC, Gonzalez GA, Fernandez I. Supercharge end-to-side nerve transfer: systematic review. Hand (NY). Accessed on 29 March 2019.

Hayashi A, Pannucci C, Moradzadeh A, Kawamura D, Magill C, Hunter D, et al. Axotomy or compression is required for axonal sprouting following end-to-side neurorrhaphy. Exp Neurol. 2008;211:539-50.

Barbour, John, Yee, Andrew, Kahn, Lorna, et al. Supercharged End-to-Side Anterior Interosseous to Ulnar Motor Nerve Transfer for Intrinsic Musculature Reinnervation. J Hand Surg. 2012;37:2150-9.

Daigeler A, Zmarsly I, Hirsch T, Goertz O, Steinau HU, Lehnhardt M, et al. Long-term outcome after local recurrence of soft tissue sarcoma: a retrospective analysis of factors predictive of survival in 135 patients with locally recurrent soft tissue sarcoma. Br J Cancer. 2014;110(6):1456-64.

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Published

2020-07-23

How to Cite

Aboosalih, S., Kamal, V. S., Venkata Mahipathy, S. R. R., Azhisoor Chandrasekhar, S. K., Krishnamurthy Mahendra, B., Prasath Jayachandiran, A., & Sundaramurthy, N. (2020). An interesting case of spindle cell sarcoma of elbow. International Surgery Journal, 7(8), 2781–2784. https://doi.org/10.18203/2349-2902.isj20203278

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Section

Case Reports