Experience with extracorporeal radiotherapy in intermediate-grade vascular neoplasm of bone tumour: a case report

Abstract Background: This report discusses a 28-year-old male patient diagnosed with an intermediate-grade vascular neoplasm in the distal diaphysis of the right femur. The tumour was excised, irradiated extracorporeally and re-implanted, demonstrating the procedure’s feasibility and effectiveness of this approach. Case Presentation: A 28-year-old male patient presented with complaints of claudication. Magnetic resonance imaging revealed a lytic lesion measuring 65 × 40 × 91 mm in the distal diaphysis of the right femur. Positron emission tomography-computed tomography evaluation identified a malignant lytic lesion in the right femur without evidence of distant metastasis. Preoperative imaging suggested malignancy. The bone segment was excised, irradiated with 50 Gy in a single fraction and re-implanted. The patient underwent open reduction, internal fixation and deep soft tissue tumour excision. Histopathology confirmed intermediate-grade vascular neoplasm without angio invasion or perineural invasion. Immunohistochemistry was positive for Pansitokeratin, Vimentin, Cytokeratin-7, D2-40 and CD31 and negative for CD34. Results: Postoperatively, the bone segment was successfully re-implanted and fixed with metal hardware. Follow-up imaging over thirty months showed successful integration with no local recurrence or metastasis. The patient recovered well without significant complications. Recommendations: Extracorporeal radiotherapy is a viable technique for treating intermediate-grade vascular bone neoplasms, providing effective tumour control and preserving limb function. This approach could be considered for broader clinical application.