Recurrent Gluteal Sarcoma Managed with Unilateral Excision of Levator Ani Muscle: Case Report
Surgical Case Reports
Soft Tissue Sarcomas (STS) are rare malignant tumors that: arise from mesenchyme, 80% arise in soft tissue while 20% in bone, and they comprise 1% adult tumors. Gluteus maximus STS is site with frequently diagnoses of high- and low-grade STS. Low-grade STS respond well to surgery alone while high-grade STS require preoperative chemoradiation therapy, followed by surgery, and then postoperative chemotherapy. Work-up includes: a core needle biopsy for histopathological diagnosis, MRI for imaging
... f local disease and Contrast enhanced CT scan for pulmonary metastasis. Recurrence is viewed as a sign of poor local treatment and a risk for distant metastasis. Reduction of local recurrence does not lead to improved survival, but lack of disease progression with pulmonary metastasis does. In our patient, laparoscopy allowed total mesorectal excision dissection and sparing of rectum, as there was no metastatic spread of tumor to the rectum. Despite excision of right levator ani muscle, our patient maintained her continence, as shown by Fucini et al.  that continence would be maintained despite dissection and separation of levator ani muscle from the anal complex unit (external and internal anal sphincter) followed by unilateral excision of levator ani muscle, while achieving good oncologic and anal function outcome. We present our management of a 55-year-old lady with recurrent gluteal STS with extension into the ischiorectal fossa managed at Tata Memorial Hospital, in Parel, Mumbai, India, in the Department of Colorectal Surgery.