Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents with a progressive, deep-seated pain in the mid-thigh, worsening at night and with physical activity. Associated with localized swelling, palpable warmth, and intermittent low-grade fevers. No history of antecedent trauma. Symptoms duration: [Insert duration]. Systemic review negative for weight loss or night sweats.
Clinical Examination Findings
Physical examination reveals a firm, tender, non-mobile mass located at the femoral diaphysis. Overlying skin shows dilated superficial veins and increased local temperature. Range of motion of the hip and knee joints is restricted due to pain. Neurovascular status of the distal extremity is intact with palpable dorsalis pedis and posterior tibial pulses.
Treatment Protocol
Multimodal therapeutic approach initiated: 1. Neoadjuvant chemotherapy (VIDE/VDC-IE protocol) to achieve local control and address micrometastases. 2. Surgical planning for limb-salvage resection of the femoral diaphysis with reconstruction. 3. Adjuvant radiotherapy indicated for positive margins or poor histological response. 4. Ongoing monitoring of hematologic and renal function.