Early tendon transfer after wide resection of an undifferentiated sarcoma of the forearm in a neonate: a case report

Abstract

A 1-month-old female baby was diagnosed with an undifferentiated sarcoma of her forearm after incisional biopsy. She received five cycles of chemotherapy before a wide resection of her extensor muscles including the radial nerve was undertaken, resulting in a complete drop of wrist and fingers. At this stage, primary tendon transfer of the brachioradialis to extensor carpi radial brevis muscle was performed, which proved to be not sufficient. Five months after resection of the tumour, restoration of the extensor function was achieved by flexor tendon transfers to provide wrist, finger and thumb extension. After 2 years, the patient did not show any signs of recurrence and she has a good wrist, finger and thumb extension and flexion. The diagnosis of an undifferentiated sarcoma is one per exclusion. Treatment includes chemotherapy and complete resection of the tumour with a wide margin. We discuss the diagnosis of undifferentiated sarcoma as well as early restoration of hand function in neonates.

Keywords: Forearm; Neonate; Tendon transfer; Undifferentiated sarcoma.