Half a month ago, the Department of Orthopedics received a patient with a left thigh mass transferred from Lin’an. The patient, male, 66 years old, was admitted to the hospital because of “progressive enlargement of the left thigh mass for 2 months”. The patient found the left thigh mass about the size of walnut 2 months ago, and the mass increased dramatically and had a diameter of 10CM before admission. After reading the MRI, Dr. Zou Cheng, deputy chief of the orthopedic department, felt that it might be a soft tissue sarcoma, and asked Dr. Fang Xin, deputy chief of the vascular surgery department, for a consultation. A biopsy was then performed in the orthopedic department, and the pathology confirmed a soft tissue sarcoma with a high probability of malignant nerve sheath tumor. Since the tumor encircled the femoral vessels and nerves, limb-preserving surgery was very difficult, so it was prepared to remove the femoral artery and vein and reconstruct the femoral artery with artificial vessels if the femoral artery could not be separated from the edge of the tumor. When the operation started to separate the blood vessels, the surgeon saw that the femoral vessels and nerves passed through the tumor and it was impossible to separate the blood vessels, so they removed the femoral artery, vein, deep femoral vein and the part of the femoral nerve penetrating the tumor. The tumor and the surrounding muscle tissue were completely excised at a distance of 2 CM from the tumor, and safe margins were obtained. Dr. Xin Fang, deputy chief of vascular surgery, successfully used artificial vessels to anastomose the stump of the femoral artery and reconstruct the blood circulation of the affected limb. After the operation, the patient had strong arterial pulsation. Postoperative pathology confirmed that the tumor was a malignant nerve sheath tumor, which invaded the femoral artery and had tumor thrombus formation in the lumen. Now the patient can walk on the ground, the limbs are mildly swollen, and there is no muscle paralysis in the lower limbs. Malignant nerve sheath tumor is a relatively rare and highly malignant soft tissue sarcoma, the incidence of which accounts for the majority of soft tissue sarcomas, mainly relying on radical surgery and postoperative adjuvant radiotherapy and chemotherapy. Soft tissue sarcoma involving the main blood vessels and nerves of the limb is exceptionally difficult to preserve the limb, and is often considered a contraindication to limb preservation, and is usually treated by amputation. The orthopedic department and the vascular surgery department worked together to complete this difficult limb-preserving surgery, taking advantage of our comprehensive hospital department. This case is the first case of limb preservation surgery for soft tissue sarcoma using artificial blood vessels to reconstruct circulation, which will accumulate valuable experience for future limb preservation surgery for this type of patients. There are not many medical units in China that can perform this type of surgery. Since it is not uncommon for soft tissue sarcoma to invade the main blood vessels of the limb, the success of this surgery brings hope for limb preservation in soft tissue sarcoma involving blood vessels.