A PLUM ON THUMB: A RARE PRESENTATION OF SYNOVIAL SARCOMA

Authors

  • Junaid Zeb Khyber teaching hospital, Peshawar
  • Hamza Zafar Khyber teaching hospital, Peshawar
  • Qaisar Khan Khyber teaching hospital, Peshawar
  • Muhammad Siraj Khyber teaching hospital, Peshawar.
  • Muhammad Ayaz Khan Khyber teaching hospital, Peshawar.

Abstract

Synovial sarcoma (SS) is a rare and aggressive mesenchymal tumour accounting for around 5–10% soft tissue neoplasms usually found in joints of upper and lower extremities. A 35years old healthy looking male patient from Afghanistan presented with swelling on palmar side of base of thumb from last one year. Seven months back excisional biopsy was taken report of which showed neurofibroma/dermatofibroma with. No evidence of malignancy seen. From last 5months mass reappeared and gradually increased in size with itching sensation and mild pain. On local examination there was 5×4×5 cm reddish mass on palmar surface of base of thumb with extension into mid thenar eminence with diffuse margins. X-ray showed soft tissue density mass with spikes of calcification. Ultrasound showed 4.2×4×4.5 cm heterogeneous solid lesion on anteromedial surface of root of right thumb without any remarkable intralesional calcification and remarkable intralesional vasculature. MRI reported lobulated well defined soft tissue mass eliciting low to intermediate signal on T1 and WIs and bright signal on T2and STIR Vividly enhancing mass. Case was operated mass was excised and biopsy sent. Post op status was unremarkable. Biopsy reported poorly differentiated biphasic synovial sarcoma. No recurrence seen till 3months.

Author Biographies

Junaid Zeb, Khyber teaching hospital, Peshawar

Resident orthopaedics & Trauma Unit Khyber teaching hospital, Peshawar

Hamza Zafar, Khyber teaching hospital, Peshawar

Resident orthopaedics & Trauma Unit Khyber teaching hospital, Peshawar

Qaisar Khan, Khyber teaching hospital, Peshawar

Registrar Orthopaedics & Trauma Unit Khyber teaching hospital, Peshawar.

Muhammad Siraj, Khyber teaching hospital, Peshawar.

Assistant Professor Orthopaedics & Trauma Unit Khyber teaching hospital, Peshawar.

Muhammad Ayaz Khan, Khyber teaching hospital, Peshawar.

Professor and Incharge Orthopaedics & Trauma Unit Khyber teaching hospital, Peshawar.

References

Banito A, Tasdemir N, Ladanyi M, Lowe SW. Defining epigenetic vulnerabilities in synovial sarcoma. Cancer Res 2015;75(15 Suppl):2866.

Dilci A, Duzlu M, Yilmaz M, Ozen IO, Pinarl FG. A rare pediatric malignant neck mass: Synovial sarcoma. Egypt J Otolaryngol 2016;32(3):232.

Harb WJ, Luna MA, Patel SR, Ballo MT, Roberts DB, Sturgis EM. Survival in patients with synovial sarcoma of the head and neck: association with tumor location, size, and extension. Head Neck 2007;29:731–40.

Ishiki H, Miyajima C, Nakao K, Asakage T, Sugasawa MD, Motoi T. Synovial Sarcoma of the head and neck: rare case of cervical metastasis. Head Neck 2009;31(1):131–5.

Rigante M, Visocchi M, Petrone G, Mule A, Bussu F. Synovial sarcoma of the parotid gland: A case report and review of the literature. Acta Otorhinolaryngol Ital 2011;31(1):43–6.

Al-Daraji W, Lasota J, Foss R, Miettinen M. Synovial sarcoma involving the head: analysis of 36 cases with predilection to the parotid and temporal regions. Am J Surg Pathol 2009;33(10):1494–503.

Ribeiro ILA, Monteiro LC, Melo ACR de, Lyra TC, Ferreira Filho JCC, Paz AR da, et al. Synovial sarcoma: case report. RGO-Rev Gaúcha Odontol 2017;65(3):260–4.

Sultan I, Rodriguez‐Galindo C, Saab R, Yasir S, Casanova M, Ferrari A. Comparing children and adults with synovial sarcoma in the Surveillance. Epidemiology, and End Results program, 1983 to 2005: an analysis of 1268 patients. Cancer 2009;115(15):3537–47.

Laila C, Ikram B, Mohamed S, Abdelkrim D, Siham T, Abdelmajid M, et al. Synovial sarcoma of hand presenting as a cystic mass. Open J Orthop 2012;2(2):59–61.

Murray PM. Soft tissue sarcoma of the upper extre mity. Hand Clin 2004;20(3):325–33.

Casal D, Ribeiro AI, Mafra M, Azeda C, Mavioso C, Mendes MM, et al. A 63-year-old woman presenting with a synovial sarcoma of the hand: a case report. J Med Case Rep 2012;6(1):385.

Gaurish SS, Avinash J, Kulkarni M, Patel D, Zode A. A rare case of monophasic synovial sarcoma of the hand: Cytological and immunohistopathological study. Oncol Gastroenterol Hepatol Rep 2015;4(2):116.

Siegel HJ, Sessions W, Casillas MA, Said-Al-Naief N, Lander PH, Lopez-Ben R. Synovial sarcoma: clinicopathologic features, treatment, and prognosis. Orthopedics 2007;30(12):1020–5.

Green D. Radial nerve palsy. Oper Hand Surg 1993;1401–17.

Downloads

Published

2021-04-30

Most read articles by the same author(s)