Management dilemma of a recurrent huge fibrosarcoma in a 25-year-old African: a case report

Abstract

IntroductionSoft tissue sarcomas are rare tumours that are infrequently seen in most surgical practices. They can occur in any anatomic region of the body. The size of a soft tissue sarcoma is an important prognostic variable and so affects the quality of tumour resection.Case presentationA 25-year-old Nigerian African presented with recurrent huge fibrosarcoma measuring about 55 × 40 × 10 cm at his posterior trunk. The patient's clinical condition was poor; the tumour seemed unresectable and the patient looked inoperable. He had an extensive excision of the tumour but could not afford adjuvant therapies. He was discharged home against medical advice but may succumb to metastases.ConclusionSarcomas in black people can present as extremely large masses; the dilemma in management is not only limited to the delay in presentation but also the poor socio-economic status of the patients and the frequent non-availability of supporting services. Treatment grants or subsidies from government may go a long way to ensuring that patients receive appropriate care.

Palliative Reconstructive Surgery: Contextualizing Palliation in Resource-Poor Settings

“…A number of authors have reported excellent outcomes following surgical palliation, even in the presence of metastases, without significant cost, in well selected patients [ 12 , 13 ]. Other reports have indicated patient benefit from wide resection of tumor, with immediate reconstruction, even in the face of positive margins, and/or potential lack of access to adjunct oncologic treatment [ 14 , 15 ].…”

“…There are not many reports in literature on palliative surgical procedures and even fewer written from the perspective of a resource-constrained environment; most are case reports [ 15 , 18 – 22 ]. Even workers from HICs well appreciate the difficulties in the care of the palliative surgical patient [ 23 ].…”