Disease-Free Recovery After Limb Salvage Surgery for Synovial Sarcoma With Femoral Vessel Involvement

Synovial sarcoma is a rare soft tissue sarcoma that often arises at a young age in the lower limbs. A large tumor size with neurovascular invasion leads to difficulties in salvaging the limb and achieving tumor-free margins during excision. Limb amputation used to be the only choice in such consideration. In addition, options for vascular reconstruction remain an open debate. Herein, we present a case of a large synovial sarcoma with the encasement of femoral vessels and the limb-salvaging approach, which employed wide excision with vessel reconstruction and their coverage in one stage. The patient recovered well with both satisfactorily aesthetic and functional outcomes at 5-year follow-up following postoperative concurrent chemoradiation therapy, and without any evidence of tumor recurrence.