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The management of soft-tissue neoplasms has always had an aura of mystique due to the relative rarity of these lesions in comparison to the more common cancers occurring in man. There are many variations in technique of the operations employed for these tumors as well. In this volume we have illus trated our own personal preferences in approach to soft tissue sarcomas with the hope it will serve as a useful guide to the surgeon who is faced with one or more of these problems. None of the operations depicted in this manual are original with us but they are procedures and approaches we have found effective for the clinical management of this family of tumors. In presenting this volume we wish to acknowledge our gratitude to our surgical teachers, our present and past associates in surgical oncology, our colleagues in the other oncologic disciplines, and our patients whose treatment is illustrated herein. We are indebted to Dr. Saul Kay, Professor of Pathology, and Dr. James Walsh, Associate Professor of Radiology, for providing the illustrations of histopathology and radiologic imaging in the early chapters. We particularly appreciate the superb artwork of our enthusiastic teammates, Trudy Nicholson and Jane Hurd, as their contribution is the crux of our endeavor. Walter Lawrence Jr., M.D. James P. Neifeld, M.D. Jose J. Terz, M.D. .
List of contents
I General Principles.- 1 Soft-Tissue Sarcomas: Etiology, Pathology, and Clinical Features.- Etiology of Soft-Tissue Sarcomas.- Clinical Presentation of Soft-Tissue Sarcoma.- Patterns of Spread of Soft-Tissue Sarcomas.- Classification of Sarcomas.- Prognostic Criteria.- Comment.- 2 Diagnosis and Staging of Soft-Tissue Sarcomas.- Clinical Presentation.- Biopsy Techniques.- Imaging Techniques.- Staging.- II Surgical Treatment of Soft-Tissue Sarcomas in Adults.- 3 Operative Treatment of Soft-Part Sarcomas.- 4 Operations for Sarcomas on the Upper Extremity.- Soft-Part Resection for Sarcoma of the Forearm.- Soft-Part Resection for Sarcoma of the Anterior Arm.- Soft-Part Resection for Sarcoma of the Posterior Arm.- Scapulectomy for Soft-Part Sarcoma.- Interscapulothoracic Amputation.- 5 Operations for Sarcomas on the Lower Extremity.- Soft-Part Resection for Sarcoma of the Anterior Thigh (Quadriceps).- Soft-Part Resection for Sarcoma in Posterior Thigh Region (Hamstring).- Soft-Part Resection of a Sarcoma Involving Calf Musculature (Gastrocnemius and Soleus).- Soft-Part Resection of Sarcoma Arising in the Buttock.- Hemipelvectomy and Hip Joint Disarticulation.- 6 Operations for Sarcomas on the Chest and Abdominal Wall.- Chest Wall Resection of Soft-Part Sarcomas.- Abdominal Wall Resection for Soft-Part Sarcoma.- 7 Retroperitoneal Sarcomas.- Retroperitoneal Sarcoma Arising in the Left Upper Quadrant.- Sarcoma Arising in the Right Retroperitoneal Space.- Sarcoma Involving the Small Bowel Mesentery.- 8 Soft-Tissue Neoplasms of the Head and Neck.- Neuroectodermal Tumors.- Paragangliomas of the Head and Neck.- Nasopharyngeal Angiofibromas.- Summary.- 9 Musculocutaneous Flaps in Reconstruction.- General Principles.- Surgical Anatomy.- Complications.- 10 Rehabilitation of the Sarcoma Patient.- III Additional Considerations in Sarcoma Management.- 11 Adjuvant Therapy for Sarcomas in Adults.- Radiation as Potential Adjuvant Therapy.- Adjuvant Chemotherapy.- Conclusions.- 12 Management of Recurrent and Metastatic Sarcomas.- Local Treatment Failure.- Distant Treatment Failure.- Surgical Treatment.- Radiation Therapy.- Chemotherapy.- 13 Special Aspects of Childhood Sarcomas.- Fibrosarcoma.- Liposarcoma.- Leiomyosarcoma.- Synovial Sarcomas.- Malignant Fibrous Histiocytoma.- Rhabdomyosarcoma.- Observations Concerning Special Anatomic Sites.- Summary.
