When Maria Rotella felt a lump on the back of her left thigh, she was concerned about a blood clot and went to urgent care. The initial diagnosis was a lipoma, a harmless, fatty tumor. The 83-year-old Perth Amboy resident didn’t think much about it for several months – until she noticed discomfort when sitting and realized it had become much larger.
Imaging tests raised the question of cancer, and Maria’s local primary care physician immediately referred her to Alexander Itskovich, MD, hepatobiliary and advanced gastrointestinal surgeon and medical director of the Statesir Cancer Center at CentraState.
Following an MRI and a biopsy, Dr. Itskovich explained to Maria and her family that the mass in her leg was sarcoma, a rare type of cancer that can begin in the bones or soft tissues. In addition, it was potentially intertwined with at least one of three major hamstring muscles and her sciatic nerve, meaning surgery would be complex and could affect her ability to walk.
“Our primary concern was to remove the cancer, but we couldn’t imagine our active mom losing mobility,” recalls her daughter, Rose Santin. “She runs her household, walks every day and is always cooking for family.”
“Despite the risks, Dr. Itskovich made me feel very confident from the beginning,” adds Maria. “He gave me a lot of hope, and I went into the surgery feeling calm.”
Surgical Precision and Collaboration
The procedure required a special level of skill to recognize distinct muscle anatomy, remove all the cancer cells and preserve as much muscle and nerve function as possible. Dr. Itskovich was able to remove the melon-sized tumor while only taking part of one hamstring muscle. CentraState reconstructive surgeon Tushar Patel, MD, was then ready to assess and repair the remaining area.
“My role was to strengthen the muscle so it would have enough power to bend the knee when walking,” explains Dr. Patel, who repositioned and sutured two muscles to strengthen the affected one. “I was also able to avoid a skin graft and use Maria’s skin to close the incision, which is better for healing and subsequent radiation treatments.”
“Patients no longer have to travel to the Manhattan or Philadelphia area for this level of care,” says Dr. Itskovich. “We approached the surgery with specialists for every part of the procedure.”
Maria woke up to a room full of happy faces and was walking with assistance by the next morning. After discharge, she underwent physical therapy to enhance healing and mobility along with radiation to prevent a recurrence. She’s now back to cooking her Italian specialties, canning sauce and walking nearly three miles a day.
“Dr. Itskovich really cared about the best outcome, so we put our trust in him,” says Maria. “And here we are, even better than expected.”
Signs and Symptoms of Sarcoma
There are more than 70 types of sarcoma, and their cause is unknown. While sarcomas are rare – representing about 1% of all cancers in adults and 15% in children – seek medical care if you have any of these symptoms:
- A lump you can feel through your skin
- Bone pain
- A broken bone that happens with only a minor injury or no injury
- Abdominal pain
- Weight loss
ONCOLOGY SERVICES AT CENTRASTATE:
Learn more about the Statesir Cancer Center at CentraState.
