A 54-year-old woman with no relevant medical history was referred to the Plastic Surgery Department due to a 2-month history of pain and right paraesthesia.
In the last weeks he had got worse, his foot had fallen and he had difficulty walking.
The patient's symptoms were suggestive of right sciatic nerve neuropathy.
Physical examination showed an increase in size in the posterior aspect of the right thigh. A deep tumor of large size, soft consistency and tenderness was observed.
Clinical examination and physical examination of the patient suggested sciatic nerve neuropathy, probably due to compression by a tumour.
We performed the following studies to specify the diagnosis:
• Magnetic resonance imaging (MRI): at the posterior compartment of the distal half of the right thigh, a mass with maximum diameters of 14 cm x 5 cm (anteroposterior signal) is visualized, with similar depth to the transverse tissue.
This mass subsequently displaces the sciatic nerve, findings that, although they could be related to stenosis, also suggest the need to rule out a low-grade liposarcoma.
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• Electromyography (EMG): compatible with sciatic nerve compression at the distal third of the right thigh.
Given the patient's clinical features and the finding of a tumor in the MRI, it was decided to perform surgical treatment of the tumor.
Surgical intervention was performed under spinal anesthesia, with resection of the tumor and release of the sciatic nerve at the tumor level.
The patient had no postoperative complications.
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The anatomopathological study of the specimen reveals macroscopically a large mass with non-surgical appearance, rounded, well-defined hemorrhagic zones, 12 x 10 x 4 cm and 266.7 gr.
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Microscopically, it is a mature adipose tissue, separated in lobes by thin fibrous tracts and numerous small-caliber vessels in the periphery.
Adipose cells do not show atypia or mitotic figures.
The patient's evolution was satisfactory, with a paulatine decrease in pain and paresthesias and gradual recovery of muscle strength to normal.
After a 15-month postoperative follow-up, the patient was asymptomatic, with no paresthesia, no pain, no gait disturbance, and no recurrence data.
