The evaluation of surgical margin between tumor and femoral artery was as follows: wide margin in six cases and marginal margin in one case. Femoral vein was sacrificed in three cases because of tumor thrombus or complete adhesion to the tumor.

In two of these three cases, femoral vein was grafted with an artificial vessel. As for the additional procedures, alcohol soaking was used in two cases, and soaking in distilled water only was performed in five cases.

In Case 5, an extraskeletal mass was adjacent to femoral vessels (Figs. 17.1 and 17.2). At the distal part of femoral vein, heterogeneous signal intensity suggested the existence of tumor thrombus; however, no calcification was found in the vein (Fig. 17.3). After intracapsular resection and cutting of the proximal femur (Fig. 17.4), the en bloc mass including tumor and femoral vessels was isolated with a vinyl sheet (Fig. 17.5). The consistency of femoral vessels was preserved. During the separation of femoral vein, a hard whitish mass was found in the vein. Since tumor thrombus was suspected, the femoral vein was sacrificed (Figs. 17.6 and 17.7). Femoral artery was preserved. After the alcohol soaking of femoral artery, femoral vein was reconstructed with an artificial vessel (Fig. 17.8). Frozen section revealed that the hard mass was tumor thrombus. Bone defect was reconstructed using an artificial knee joint (Figs. 17.8 and 17.9). Lung metastases appeared 8 months after the operation. The removal of lung metastases was performed two times. Seven years and 6 months after the resection of primary lesion, this patient remained disease free.