We studied 123 patients with malignant peripheral nerve sheath tumours (MPNSTs) between 1979 and 2002. However, 90 occurred sporadically whereas 33 were associated with neurofibromatosis type 1 (NF1). Survival was calculated using Kaplan-Meier survival curves and we used Cox's proportional hazards model to identify independent prognostic factors. A 5-year survival for 110 nonmetastatic patients was 54%; (33% NF1 and 63% sporadic P = .015). Tumour stage and site were significant prognostic indicators after univariate analysis. After multivariate analysis, however, only NF1 (P = .007) and tumour volume more than 200 m (P = .015) remained independent predictors of poor outcome. We recommend that NF1 be taken into account during MPNST staging. As the survival rate in the NF group was dependant on tumour volume, routine screening of these patients with FDG PET and/or MRI may be warranted, thereby staging and controlling them at the earliest possible opportunity.

We describe a 72-year-old woman with a false aneurysm of the mid-popliteal artery after a total knee replacement, presenting with a pulsatile swelling and an audible bruit in the popliteal fossa. The diagnosis was confirmed by duplex ultrasound. Surgical repair was undertaken using a saphenous vein patch to reconstruct the arterial defect. A false aneurysm of the popliteal artery following total knee replacement is an extremely rare occurrence. To our knowledge, only four other cases have been reported in the English-language literature.

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