Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents with a persistent, localized pain in the lateral aspect of the lower leg, progressively worsening over [Duration]. Associated with palpable mass, localized swelling, and nocturnal pain. No history of trauma. Systemic symptoms include intermittent low-grade fever, fatigue, and weight loss.
Clinical Examination Findings
Physical examination reveals a firm, non-mobile, tender mass over the fibular shaft. Overlying skin shows erythema and increased local warmth. Neurovascular status of the distal extremity is intact (DP/PT pulses 2+, capillary refill <2s). No palpable inguinal lymphadenopathy. Gait assessment demonstrates an antalgic limp.
Treatment Protocol
Multidisciplinary management initiated. Plan includes neoadjuvant chemotherapy (VIDE/VDC-IE protocol) to achieve tumor shrinkage, followed by surgical resection of the fibula with wide margins. Post-operative adjuvant chemotherapy and consideration for radiotherapy depending on pathological margins and histological response.