Synovial sarcoma under the lens: a case report

Abstract

Synovial sarcoma, an uncommon malignant tumor, can occur in various anatomical sites but mostly involves joints. It is invasive locally and tends to spread to other sites. We report a male patient, 56 years old, who had swelling above his right ankle. Soft tissue edema was observed across the lateral malleolus in imaging examinations. A synovial sarcoma was diagnosed on histopathology. A complete resection was performed and postoperative treatment with doxorubicin and cyclophosphamide was given for 2 months. The 5-year survival rate is only expected between 27-55%. Furthermore, many authors concur that synovial sarcomas are among the most frequently misdiagnosed soft tissue cancers due to their sluggish growth pattern, benign radiographic appearance, capacity to fluctuate in size, and potential to induce pain similar to that brought on by ordinary trauma. Therefore, the case emphasizes the need for additional study to identify the best diagnostic approaches for synovial sarcoma.

Keywords: Synovial sarcoma; case report; spindle cells; swelling; wavy collagen.

Figure 1

swelling over lateral malleolus of the right ankle (Arrow)

Figure 2

evidence of soft tissue swelling over lateral malleolus of right ankle (Arrow)

Figure 3

cut-section of an excised specimen of swelling

Figure 4

microscopic examination [H&E,40X]- the arrow showing fascicles of spindle cells, and thickened bundle of wavy collagen