Lipossarcoma de joelho em um atleta de tênis: relato de caso

Abstract

CASE REPORTThe patient was a 40-year-old white man who was an amateur tennis player. He came to the orthopedics and traumatology outpatient clinic at the Assunção Hospital and Maternity Hospital, in São Bernardo do Campo, São Paulo, presenting tumor formation in his right lower limb that had started around one year earlier, with gradual progression. He said that he had not had any other symptoms such as pain, fever, nausea or weight loss.On physical examination, he presented a good general state and was eutrophic, not jaundiced, not cyanotic and not febrile. On orthopedic examination, he presented painless tumor growth on the posterior face of the right knee and distal thigh, with fibroelastic consistency and without any temperature difference.Radiographs of the knee were requested and showed increased soft-tissue volume. Ultrasound showed a mass of solid appearance measuring 15 x 20 cm. Because of this, computed tomography and magnetic resonance imaging were requested to assess the tumor formation better. At that time, it was suspected that the diagnosis could be liposarcoma and therefore imaging examinations were requested for staging purposes (radiographs on the lungs, bone scintigraphy, PET SCAN and tomography on the chest, abdomen, pelvis and cranium). These were found to be normal (Figures 1 to 3).With these findings, surgical treatment was scheduled (radical tumor excision). During the operation, a tumor measuring 18 x 20 cm was removed, and this was sent for anatomopathological analysis (Figures 4 and 5).The anatomopathological diagnosis was that this was a case of myxoid liposarcoma, with free margins. The oncologist who was following up the case with the orthopedist advised that adjuvant radiotherapy should be administered, and this was done (Figure 6).Two years after the operation, the patient is asymptomatic (without recurrence or metastasis) and is continuing to practice tennis. DISCUSSIONSarcomas are rare tumors and originate from primitive mesenchymal cells. They account for 0.1 to 0.2 % of all cases of neoplasia in adults (1)(2)(3) .