학술논문
A rare occurrence of a giant synovial sarcoma in the plantar region of the foot: A case report.
Document Type
Report
Author
Fadili O; Department of Trauma Surgery and Orthopaedics, Ibn Rochd University Hospital Center, Casablanca, Morocco; Faculty of Medicine and Pharmacy of Casablanca, Hassan II University, Morocco. Electronic address: drfadiliomar@outlook.fr.; Chrak A; Department of Trauma Surgery and Orthopaedics, Ibn Rochd University Hospital Center, Casablanca, Morocco; Faculty of Medicine and Pharmacy of Casablanca, Hassan II University, Morocco.; Laffani M; Department of Trauma Surgery and Orthopaedics, Ibn Rochd University Hospital Center, Casablanca, Morocco; Faculty of Medicine and Pharmacy of Casablanca, Hassan II University, Morocco.; El Adaoui O; Department of Trauma Surgery and Orthopaedics, Ibn Rochd University Hospital Center, Casablanca, Morocco; Faculty of Medicine and Pharmacy of Casablanca, Hassan II University, Morocco.; Messoudi A; Department of Trauma Surgery and Orthopaedics, Ibn Rochd University Hospital Center, Casablanca, Morocco; Faculty of Medicine and Pharmacy of Casablanca, Hassan II University, Morocco.; Fadili M; Department of Trauma Surgery and Orthopaedics, Ibn Rochd University Hospital Center, Casablanca, Morocco; Faculty of Medicine and Pharmacy of Casablanca, Hassan II University, Morocco.
Source
Publisher: Elsevier B.V Country of Publication: Netherlands NLM ID: 101529872 Publication Model: Print-Electronic Cited Medium: Print ISSN: 2210-2612 (Print) Linking ISSN: 22102612 NLM ISO Abbreviation: Int J Surg Case Rep Subsets: PubMed not MEDLINE
Subject
Language
English
ISSN
2210-2612
Abstract
Introduction and Significance. Synovial sarcoma, accounting for 7-8 % of malignant sarcomas, typically manifests in adulthood, but it is noteworthy that adolescents and children make up 30 % of reported cases. Contrary to its name, this malignancy often originates from multipotent stem cells rather than the synovium. This report highlights a rare case involving a 23-year-old male with a localized synovial sarcoma in the plantar region, underscoring the importance of recognizing radiological signs for an accurate diagnosis.
Case Presentation: A 23-year-old male, a chronic smoker, presented with a 5-year history of a mass on the plantar region of the right foot. Following an excision biopsy, the tumor recurred after two years, significantly impacting mobility. Radiological imaging revealed a cloud-like soft tissue mass. Surgical biopsy confirmed biphasic synovial sarcoma. A multidisciplinary consultation guided the decision for transtibial amputation and adjuvant chemotherapy. Postoperatively, the patient experienced a superficial infection, effectively treated, with subsequent positive outcomes and successful prosthetic adaptation.
Discussion: Synovial sarcoma, a rare and aggressive soft tissue malignancy, predominantly affects young individuals and often develops peri-articularly, presenting diagnostic challenges. Imaging modalities, particularly MRI, play a pivotal role in diagnosis, showcasing characteristic features. The primary treatment involves surgical intervention, with chemotherapy and radiotherapy contributing to local control. Despite advancements, recurrence rates remain significant, necessitating vigilant follow-up.
Conclusion: Synovial sarcoma of the extremities is characterized by insidious progression and a high metastatic risk. MRI, while nonspecific, is indispensable for diagnostic orientation, later confirmed through histological examination. Surgery remains the mainstay therapy, with radiotherapy and chemotherapy contributing to enhanced local control. The awareness of this rare malignancy and its diagnostic and therapeutic nuances is crucial for optimal patient management and outcomes.
Competing Interests: Declaration of competing interest None. Research registration (for case reports detailing a new surgical technique or new equipment/technology). None.
(Copyright © 2024. Published by Elsevier Ltd.)
Case Presentation: A 23-year-old male, a chronic smoker, presented with a 5-year history of a mass on the plantar region of the right foot. Following an excision biopsy, the tumor recurred after two years, significantly impacting mobility. Radiological imaging revealed a cloud-like soft tissue mass. Surgical biopsy confirmed biphasic synovial sarcoma. A multidisciplinary consultation guided the decision for transtibial amputation and adjuvant chemotherapy. Postoperatively, the patient experienced a superficial infection, effectively treated, with subsequent positive outcomes and successful prosthetic adaptation.
Discussion: Synovial sarcoma, a rare and aggressive soft tissue malignancy, predominantly affects young individuals and often develops peri-articularly, presenting diagnostic challenges. Imaging modalities, particularly MRI, play a pivotal role in diagnosis, showcasing characteristic features. The primary treatment involves surgical intervention, with chemotherapy and radiotherapy contributing to local control. Despite advancements, recurrence rates remain significant, necessitating vigilant follow-up.
Conclusion: Synovial sarcoma of the extremities is characterized by insidious progression and a high metastatic risk. MRI, while nonspecific, is indispensable for diagnostic orientation, later confirmed through histological examination. Surgery remains the mainstay therapy, with radiotherapy and chemotherapy contributing to enhanced local control. The awareness of this rare malignancy and its diagnostic and therapeutic nuances is crucial for optimal patient management and outcomes.
Competing Interests: Declaration of competing interest None. Research registration (for case reports detailing a new surgical technique or new equipment/technology). None.
(Copyright © 2024. Published by Elsevier Ltd.)