In epithelioid sarcoma with limb involvement and aggressive behavior, which surgical approach is commonly preferred?

• A. Amputation
• B. Wide local excision with limb preservation
• C. Limb-sparing resection with reconstructive graft
• D. Observation

Answer: (A)

Epithelioid sarcoma in a limb tends to infiltrate locally and recur if margins are not fully removed, making durable local control difficult. Because this tumor can spread along fascial planes and be difficult to resect cleanly without sacrificing substantial tissue, amputation has historically been chosen to maximize the chance of complete tumor removal with clear margins in a severely involved limb. This approach reduces the likelihood of residual disease and subsequent local recurrence when the extent of involvement makes limb-sparing resections unreliable. Observing the tumor or opting for limb-sparing procedures with reconstructive grafts carries a higher risk of leaving microscopic disease behind in aggressive cases.