Leiomyosarcomas of the Great Saphenous Vein: Diagnostic and Therapeutic Strategies to Prevent Unplanned Excisions and Improve Oncologic, Functional, and Psychological Outcomes

Ramos Pascua, Luis R.; Ramos García, Elena; Robustillo Rego, Manuel; Méndez, Violeta González; Enguita Valls, Ana Belén; Mora Fernández, María I.; Valladolid, Gabriel Rubio; Vilá y Rico, Jesús E.

doi:10.3390/diseases13100330

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Leiomyosarcomas of the Great Saphenous Vein: Diagnostic and Therapeutic Strategies to Prevent Unplanned Excisions and Improve Oncologic, Functional, and Psychological Outcomes

by

Luis R. Ramos Pascua

^1,2,3,

Elena Ramos García

^4,*,†,

Manuel Robustillo Rego

⁵,

Violeta González Méndez

⁶,

Ana Belén Enguita Valls

^2,7,

María I. Mora Fernández

⁸,

Gabriel Rubio Valladolid

^2,9,†

and

Jesús E. Vilá y Rico

^1,2

¹

Department of Trauma and Orthopaedics Surgery, University Hospital 12 de Octubre, Av/Córdoba, s/n, Usera, 28041 Madrid, Spain

²

School of Medicine, Complutense University, Pl. de Ramón y Cajal, s/n, Moncloa-Aravaca, 28040 Madrid, Spain

³

Department of Trauma and Orthopaedics Surgery, University Hospital Quirónsalud, C/Diego de Velázquez, 1, Pozuelo de Alarcón, 28223 Madrid, Spain

⁴

Department of Psychiatry, Hospital General Universitario Nuestra Señora del Prado, Ctra/Madrid-Extremadura, Km 114, s/n, 45600 Talavera de la Reina, Spain

⁵

Department of Plastic and Reconstructive Surgery, University Hospital 12 de Octubre, Av/Córdoba, s/n, Usera, 28041 Madrid, Spain

⁶

Department of Radiology, University Hospital 12 de Octubre, Av/Córdoba, s/n, Usera, 28041 Madrid, Spain

⁷

Department of Pathology, University Hospital 12 de Octubre, Av/Córdoba, s/n, Usera, 28041 Madrid, Spain

⁸

Department of Trauma and Orthopaedic Surgery, University Hospital of Burgos, Av. Islas Baleares, 3, 09006 Burgos, Spain

⁹

Department of Psychiatry, University Hospital 12 de Octubre, Av/Córdoba, s/n, Usera, 28041 Madrid, Spain

^*

Author to whom correspondence should be addressed.

^†

These authors contributed equally to this work.

Diseases 2025, 13(10), 330; https://doi.org/10.3390/diseases13100330

Submission received: 10 June 2025 / Revised: 8 September 2025 / Accepted: 27 September 2025 / Published: 6 October 2025

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Abstract

Background/Objectives: There are very few publications on unplanned excisions of great saphenous vein leiomyosarcomas (GSV-LMS), and their impact on the prognosis of the disease is not well known. The objective of this study is to present a series of nine new leiomyosarcomas of the great saphena vein (LMS-GSV) cases, with the aim of increasing diagnostic awareness and proposing guidelines for therapeutic management. Methods: This is a prospective single-centre study of a series of nine GSV-LMS in thigh (stage IIIA AJCC), knee and proximal leg (IB, 1 II and 3 IIIA), and ankle (2 IIIB and 1 II). Eight patients were female, and the mean age was 72 years. All patients were surgically treated. Five (56%) were unplanned excisions. All these patients were reoperated on to attempt wide resection margins. In a patient, an infra-patellar amputation was performed. Another amputation was refused by another patient. Eight patients received adjuvant radiotherapy. Results: One patient died 8 years after amputation for a reason other than LMS. The patient who refused amputation has been alive, disease-free, for 28 months. The mean follow-up of surviving patients was 39 months (6–78 months). In these patients, there were no local recurrences or metastases. The mean functional outcome according to the MSTS score was 28.9 (range: 24–30). Conclusions: Unplanned excision of GSV-LMS can be prevented through clinical and imaging suspicion. Surgery and re-excision in case of inadequate previous margins and adjuvant radiotherapy lead to a good oncological and functional outcome.

Keywords: soft tissue sarcoma; leiomyosarcoma; great saphenous vein; excision; unplanned excision; subcutaneous; superficial; thigh; knee; ankle

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MDPI and ACS Style

Ramos Pascua, L.R.; Ramos García, E.; Robustillo Rego, M.; Méndez, V.G.; Enguita Valls, A.B.; Mora Fernández, M.I.; Valladolid, G.R.; Vilá y Rico, J.E. Leiomyosarcomas of the Great Saphenous Vein: Diagnostic and Therapeutic Strategies to Prevent Unplanned Excisions and Improve Oncologic, Functional, and Psychological Outcomes. Diseases 2025, 13, 330. https://doi.org/10.3390/diseases13100330

AMA Style

Ramos Pascua LR, Ramos García E, Robustillo Rego M, Méndez VG, Enguita Valls AB, Mora Fernández MI, Valladolid GR, Vilá y Rico JE. Leiomyosarcomas of the Great Saphenous Vein: Diagnostic and Therapeutic Strategies to Prevent Unplanned Excisions and Improve Oncologic, Functional, and Psychological Outcomes. Diseases. 2025; 13(10):330. https://doi.org/10.3390/diseases13100330

Chicago/Turabian Style

Ramos Pascua, Luis R., Elena Ramos García, Manuel Robustillo Rego, Violeta González Méndez, Ana Belén Enguita Valls, María I. Mora Fernández, Gabriel Rubio Valladolid, and Jesús E. Vilá y Rico. 2025. "Leiomyosarcomas of the Great Saphenous Vein: Diagnostic and Therapeutic Strategies to Prevent Unplanned Excisions and Improve Oncologic, Functional, and Psychological Outcomes" Diseases 13, no. 10: 330. https://doi.org/10.3390/diseases13100330

APA Style

Ramos Pascua, L. R., Ramos García, E., Robustillo Rego, M., Méndez, V. G., Enguita Valls, A. B., Mora Fernández, M. I., Valladolid, G. R., & Vilá y Rico, J. E. (2025). Leiomyosarcomas of the Great Saphenous Vein: Diagnostic and Therapeutic Strategies to Prevent Unplanned Excisions and Improve Oncologic, Functional, and Psychological Outcomes. Diseases, 13(10), 330. https://doi.org/10.3390/diseases13100330

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Leiomyosarcomas of the Great Saphenous Vein: Diagnostic and Therapeutic Strategies to Prevent Unplanned Excisions and Improve Oncologic, Functional, and Psychological Outcomes

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