Question:

Management of fistulation in soft-tissue sarcoma:
1. is well described in the literature
2. is usually surgical
3. can be endoscopic
4. is best undertaken by Oncologists
5. has no role for radiotherapy





Answer:

The correct answer for the question "Management of fistulation in soft-tissue sarcoma:" is:

3. can be endoscopic



Explanation
1. [Being a rarely reported phenomenon, there are no guidelines or literature to recommend the best way of managing fistulation in soft-tissue sarcomas.]

2. […surgical resection of the fistula tract and associated viscera is rarely possible in the context of soft-tissue sarcomas. The intra-abdominal disease bulk can often be large, and patients often have high perioperative risk…]

3. [We have, however, demonstrated other non-surgical approaches with endoscopic stenting and radiotherapy, which also resulted in a positive outcome.]

4. […decisions regarding management were made in a multidisciplinary setting on an individual basis, ensuring the best outcome for the patient.]

5. [We have, however, demonstrated other non-surgical approaches with endoscopic stenting and radiotherapy, which also resulted in a positive outcome.]



From the manuscript:
Fistulation as a complication of intra-abdominal soft-tissue sarcomas; a case series
Radiology Case. 2013 Jun; 7(6):15-21


This article belongs to the GI section.




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From the manuscript

Fistulation as a complication of intra-abdominal soft-tissue sarcomas; a case series

Free full text article: Fistulation as a complication of intra-abdominal soft-tissue sarcomas; a case series

Abstract
Soft-tissue sarcomas are rare, accounting for only one percent of all cancers. They can occur in retroperitoneal and intraperitoneal sites, including gastrointestinal stromal tumours (GIST), and have the potential to cause complications secondary to interaction with other abdominal viscera. Fistulation, or an abnormal communication between two epithelium-lined surfaces that do not usually connect, is a rare example of such a complication. We present a series of cases of fistulation due to the presence of an intra-abdominal soft-tissue sarcoma and contrast three different approaches to management. We discuss the radiological features and other modalities of imaging which may be useful in diagnosing this rare complication.






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