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This case report describes malignant PEComa arising from the femur in an elderly patient, treated with surgical resection followed by adjuvant radiotherapy. The patient achieved a favorable therapeutic outcome, with delayed recurrence. The authors suggest this combined treatment approach may be a feasible option for elderly patients and provides clinical reference for managing this rare tumor entity.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/femoral-pecoma-treated-with-combined-surgery-and-radiotherapy-a-case-report/407336/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/femoral-pecoma-treated-with-combined-surgery-and-radiotherapy-a-case-report/407336.png","ImageObject",300,407,{"name":92,"@type":93},"Levi","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-11-02","2026-09-28",true,{"@type":102,"interactionType":103,"userInteractionCount":39},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"What tumor type is described in the case report?","Question",{"text":112,"@type":113},"The report describes malignant perivascular epithelioid cell tumor (PEComa) originating in the femur.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"How was the patient treated?",{"text":117,"@type":113},"Treatment included surgical resection and adjuvant radiotherapy after excision.",{"name":119,"@type":110,"acceptedAnswer":120},"What is the reported clinical outcome of the combined treatment?",{"text":121,"@type":113},"The combined approach effectively delayed tumor recurrence and resulted in long-term progression-free survival.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},407336,1790922127,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":39,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":139,"language":140,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":141,"faqs":142,"seo_title":143,"seo_description":67,"update_tm":144,"read_time":145,"preview_page_count":4},7971461740909,"https://ap-avatar.wpscdn.com/davatar_155a257f0dc6eb9ab79c44ca47cae57d","Clinical Case Reports  \nCASE REPORT  OPEN ACCESS   \nFemoral PEComa Treated With Combined Surgery and Radiotherapy: A Case Report  \nYanluqi He1  | Kaili Fu1 | Ling Xue2 | Yaohua Fan1 | Dongjuan Wu1  \n1Department of Oncology, The Second Affiliated Hospital of Jiaxing University, Jiaxing, Zhejiang, China | 2Department of Pathology, The Second Affiliated  \nHospital of Jiaxing University, Jiaxing, Zhejiang, China Correspondence: Dongjuan Wu ([15988355272@163.com](15988355272@163.com))  \nReceived: 22 July 2025 | Revised: 9 November 2025 | Accepted: 19 December 2025  \nKeywords: bone | case report | PEComa | radiotherapy | surgery  \n\n| ABSTRACT\u003Cbr>Perivascular epithelioid cell tumor (PEComa) is a rare mesenchymal tumor, and primary involvement of the bone is exceptionally uncommon. In this report, a case of malignant PEComa arising from the femur in an elderly patient is described. The patient achieved a favorable therapeutic outcome following surgical resection and adjuvant radiotherapy. This case suggests that this treatment mode may represent a feasible option for elderly patients and provides a valuable reference for clinical management of this rare tumor type. |  |\n| --- | --- |\n| 1 | Introduction | primary osseous PEComas are extremely rare. Only sporadic cases and small case series have been reported, leaving their |\n| Perivascular epithelioid cell tumor (PEComa) is a rare mesen- | clinicopathological features and optimal treatment strategies |\n| chymal tumor composed of perivascular epithelioid cells (PECs) | poorly defined. Currently, no standardized therapeutic protocol |\n| with a distinctive morphology and immunophenotype, first de- | exists, and management generally relies on multidisciplinary |\n| scribed by Bonetti [1]. As a tumor family, PEComa encompasses | evaluation. This report describes a case of malignant PEComa |\n| multiple subtypes, including angiomyolipoma (AML), lymph- | originating in the femur of an elderly patient who received post- |\n| angioleiomyomatosis (LAM), clear cell “sugar” tumors (CCST), | operative adjuvant radiation therapy following surgical excision. |\n| clear cell myomelanocytic tumor (CCMMT), and non-specific | This case aims to contribute to the understanding of the diagno- |\n| types collectively referred to as PEComa-not otherwise specified (PEComa-NOS) [2] . All these subtypes share common features: morphologically, tumor cells are epithelioid or spindle shaped | sis and treatment of PEComa arising in rare sites. |\n| containing abundant clear or eosinophilic cytoplasm and prominent nucleoli, and are typically arranged radially around blood | 2 | Case History/Examination |\n| vessels. Immunohistochemistry reveals that the cells usually ex- | An 81-year-old male presented with a one-year history of |\n| press melanocytic markers (HMB-45 and Melan-A), and smooth | left knee pain that worsened over the preceding 2 weeks. |\n| muscle markers (SMA and desmin), and some of them may also | Computed tomography (CT) of the left knee performed at a |\n| express cathepsin K [3] . | local hospital revealed bone destruction in the medial femoral condyle accompanied by a soft tissue mass, raising suspicion of |\n| PEComas most frequently occur in the uterus, skin, liver, kid- | a malignant tumor. The patient initially received conservative |\n| ney, abdominopelvic soft tissue, and retroperitoneum, whereas | treatment consisting of celecoxib for pain and inflammation, |\n| Yanluqi He and Kaili Fu share first authorship. |  |\n| This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.\u003Cbr>© 2025 The Author(s). Clinical Case Reports published by John Wiley & Sons Ltd. |  |\n\nClinical Case Reports, 2026; 14:e71754 1 of 11  \n[https://doi.org/10.1002/ccr3.71754](https://doi.org/10.1002/ccr3.71754)  \nKey Clinical Message  \nAn elderly patient with malignant PEComa was diagnosed ba","cbCaijdwV1fW1dC2","https://ap.wps.com/l/cbCaijdwV1fW1dC2","pdf",2542400,11,"English","# Abstract\n## Introduction\n## Case History/Examination\n## Differential Diagnosis, Investigations and Treatment","[{\"question\":\"What tumor type is described in the case report?\",\"answer\":\"The report describes malignant perivascular epithelioid cell tumor (PEComa) originating in the femur.\"},{\"question\":\"How was the patient treated?\",\"answer\":\"Treatment included surgical resection and adjuvant radiotherapy after excision.\"},{\"question\":\"What is the reported clinical outcome of the combined treatment?\",\"answer\":\"The combined approach effectively delayed tumor recurrence and resulted in long-term progression-free survival.\"}]","Femoral PEComa Treated With Combined Surgery and Radiotherapy - A Case Report | PDF",1790573127,28]