A Fuc chondrosarcoma Rt thigh post op/ post Rt. Presented with unilateral massive Rt lower limb lymphedema. Coloured doppler was normal. Got a PET CTdone. Pls discuss further management.

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Good pain control, srart opioids, can consider for ifosfamide adria platinum IAP palliative chemotherapy, see if it responds, if it does not palliative rt to the tumour mass compressing aorta,, prognosis is bleak. consider good palliative care.
Proper assessment of symptoms, inform the family and patient about the stage of disease. Care of lymphoedema. Good Palliative care.
Very unfortunate. Nothing much can be done now. Explain prognosis and best supportive care. Can start morphine
Palliative treatment & care.
1. need to know the histopathology because if it was dedifferentiated then cave treated as relapsed OGS 2. or if this is mesenchymal then can be treated as relapsed Ewing's Sarcoma 3. If neither dedifferentiated nor mesenchymal then options are Palliative care or Cyclophosphamide and sirolimus with marginal benefit
Start Morphine 10 mg @ regular 4th Helu interval. explaining the risk of constipation and excessive sedation. He will be painted as long as he survives
Start Morphine 10 mg @ regular 4th Helu interval. explaining the risk of constipation and excessive sedation. He will be painted as long as he survives
best supportive care and analgesia alone. had the disease been more distal, we could have considered hindquarter amputation
Very unfortunate. I'd discuss with the family regarding the prognosis... and initiate morphine.
Pall chemo ifos and adriamycin can be tried.Pain contol with morphine 30 mg SR twice a day
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