Multi-Step Combined Upfront Surgery for Locally Advanced Paravertebral Sarcoma: A Case Report

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Background: Paravertebral localization of primary undifferentiated pleomorphic sarcoma (UPS) with bone and vascular involvement is infrequent and challenging. Multi-step surgical procedure has been described as a feasible and effective option to achieve sustained local tumor control. Methods: We report on a 62-year old man with paravertebral UPS infiltrating the aortic wall and the 9th thoracic vertebra who underwent a multi-step surgical procedure aimed at achieving oncologic radicality through a coordinated effort between thoracic, vascular and spinal surgeons. After balancing the risks and benefits of perioperative therapies, upfront surgery was performed including aortic resection with bypass grafting followed by a triple en bloc vertebrectomy with tumor excision. Mid-term follow-up (22 months) is then provided. Results: The combined procedure achieved oncological radicality and no local recurrence in the mid-term. No major complications occurred. Conclusions: Multi-step and multi-specialty surgery is a feasible and effective strategy to treat primary UPS in unfavorable localization. A strategic cooperation between surgeons and a multidisciplinary tumor board is required to define an optimal, personalized treatment strategy in sarcoma patients.

Original languageEnglish
Article number664089
JournalFrontiers in Surgery
Publication statusPublished - Apr 26 2021


  • aorta–thoracic
  • multidisciplinary (treatment)
  • sarcoma
  • surgery
  • UPS
  • vertebra bone

ASJC Scopus subject areas

  • Surgery


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