# A Rapidly Progressing Lower Extremity Soft Tissue Sarcoma in an Adolescent Patient

**Authors:** Chenxi Shi, Lydia Espinoza

PMC · DOI: 10.7759/cureus.102963 · 2026-02-04

## TL;DR

A rare and fast-growing soft tissue sarcoma in an adolescent girl was initially mistaken for a muscle strain, highlighting the need for early suspicion of cancer in such cases.

## Contribution

The paper presents a rare case of rapidly progressive lower extremity sarcoma in an adolescent, emphasizing the importance of early diagnosis.

## Key findings

- The patient's symptoms worsened over three months with a rapidly enlarging calf mass.
- The case resulted in widespread metastatic disease due to delayed diagnosis.
- Timely referral to a specialized sarcoma center is crucial for proper evaluation and treatment.

## Abstract

Soft tissue sarcomas (STSs) are rare malignant tumors of mesenchymal origin with heterogeneous histologic subtypes and variable clinical behavior. Although STSs most commonly arise in the extremities, rapidly progressive sarcomas involving the distal lower extremity in adolescents have not been well documented. We report a case of an STS in a previously healthy adolescent female whose initial presentation was presumed to be a muscle strain. Over a three-month period, her symptoms worsened with progressive enlargement of a calf mass and development of widespread metastatic disease. This case highlights the importance of maintaining suspicion for malignancy in rapidly enlarging soft tissue masses, with timely referral to specialized sarcoma centers for further evaluation.

## Full-text entities

- **Genes:** SOX10 (SRY-box transcription factor 10) [NCBI Gene 6663] {aka DOM, PCWH, SOX-10, WS2E, WS4, WS4C}, PTPRC (protein tyrosine phosphatase receptor type C) [NCBI Gene 5788] {aka B220, CD45, CD45R, GP180, IMD105, L-CA}, CD99 (CD99 molecule (Xg blood group)) [NCBI Gene 4267] {aka HBA71, MIC2, MIC2X, MIC2Y, MSK5X}, WT1 (WT1 transcription factor) [NCBI Gene 7490] {aka AWT1, GUD, NPHS4, WAGR, WIT-2, WT-1}, SMARCB1 (SWI/SNF related BAF chromatin remodeling complex subunit B1) [NCBI Gene 6598] {aka BAF47, CSS3, INI-1, INI1, MRD15, PPP1R144}, CRP (C-reactive protein) [NCBI Gene 527553], SMARCA4 (SWI/SNF related BAF chromatin remodeling complex subunit ATPase 4) [NCBI Gene 6597] {aka BAF190, BAF190A, BRG1, CSS4, MRD16, OTSC12}, DES (desmin) [NCBI Gene 1674] {aka CDCD3, CSM1, CSM2, LGMD1D, LGMD1E, LGMD2R}, S100A1 (S100 calcium binding protein A1) [NCBI Gene 6271] {aka S100, S100-alpha, S100A}, FOXO1 (forkhead box O1) [NCBI Gene 2308] {aka FKH1, FKHR, FOXO1A}, MYOG (myogenin) [NCBI Gene 4656] {aka MYF4, bHLHc3, myf-4}
- **Diseases:** pleural effusion (MESH:D010996), autoimmune (MESH:D001327), rhabdomyosarcoma (MESH:D012208), connective tissue tumor (MESH:D009372), fatigue (MESH:D005221), hypercoagulability (MESH:D019851), muscle strain (MESH:D013180), muscle tightness (MESH:C536920), respiratory distress (MESH:D012128), neutropenic fever (MESH:D005334), STSs (MESH:D012509), neurofibromatosis type I (MESH:D009456), SLE (MESH:D008180), trauma (MESH:D014947), inflammatory (MESH:D007249), leiomyosarcoma (MESH:D007890), pain (MESH:D010146), hereditary cancer (MESH:D009386), liposarcoma (MESH:D008080), pleural mass (MESH:D010995), osseous lesions (MESH:D000070896), shoulder pain (MESH:D020069), pulmonary (MESH:D008171), calcifications (MESH:D002114), Tumours (MESH:D009369), Lyme disease (MESH:D008193), edema (MESH:D004487), pulmonary nodules (MESH:D055613), undifferentiated sarcoma (MESH:D002277), deformity (MESH:D009140), hereditary retinoblastoma (MESH:D012175), muscle ache (MESH:D063806), Li-Fraumeni syndrome (MESH:D016864), constipation (MESH:D003248), microcytic anemia (MESH:C536357), malignant smooth muscle tumors (MESH:D018235), benign soft tissue mass (MESH:D017695), anemia (MESH:D000740), polyarthritis (MESH:D001168), rheumatoid arthritis (MESH:D001172), metastases (MESH:D009362), STS (MESH:D016114), deep vein thrombosis (MESH:D020246), weight loss (MESH:D015431), soft tissue tumors (MESH:D012983), Ewing sarcoma (MESH:D012512)
- **Chemicals:** iron (MESH:D007501), mesna (MESH:D015080), AIM (MESH:C427526), ifosfamide (MESH:D007069), Adriamycin (MESH:D004317)
- **Species:** Bos taurus (bovine, species) [taxon 9913], Homo sapiens (human, species) [taxon 9606]

## Figures

3 figures with captions in the complete paper: https://tomesphere.com/paper/PMC12965299/full.md

---
Source: https://tomesphere.com/paper/PMC12965299