Sarcoma metastases due to iatrogenic implantation

Aim To demonstrate the ability of extremity soft tissue sarcomas (STSs) to implant into tissues exposed during surgery. Methods We use two cases to illustrate that wounds created during surgery for STSs, including donor sites for skin grafts, pedicled and free flaps and blood vessels used in reconstruction, should be regarded as potential sites of quasi-local recurrence. Conclusions This report reinforces the need for meticulous surgical technique and planning of procedures to avoid contamination of clean areas that might not be included in adjuvant radiotherapy fields. The cases also highlight the pivotal importance of the correct initial management of these uncommon tumours.