Fig. 1

Surgical procedure and post-operative limb function in case 2, (a) T2 weighted-MR image showing clear cell sarcoma located intra-tendinously at calcaneal tendon. b After the elevation of the tumor mass, including the tendon and nerve from the tumor bed, a 6-mm-thick lead boards were inserted beneath the tumor mass to shield the normal tissue (c). The patients were transferred to the radiotherapy department after the affected limbs were wrapped in sterilized plastic bags, and 35–50 Gy of 12 MeV electrons were delivered. d After irradiation, the patients were returned to the operation room, and underwent the marginal/intra-lesional resection of the tumor, preserving the tendon and nerve. e The soft tissue defect was then reconstructed using a free musculocutaneous flap. The photographs at the final follow-up time showing the normal ankle movement (f and g) and ability of stand on toe (h)