Presentation
Swelling and moderate pain of the right hindfoot, that had evolved over a period of 4 months.
Patient Data
Large hypervascular masses around the deep flexor tendons at the medial and the peroneal tendons at the lateral aspect of the hindfoot. Large T1-hypointense bone lesion of the calcaneus, also with patchy enhancement. No apparent fluid collections.
The calcaneus shows destructions of its cortical borders, mainly at the medial aspect. There are more circumscript, ill-defined osteolytic lesions and a more permeative pattern of bone infiltration. Note the tumor calcifications of the medial synovial mass.
Case Discussion
Excisional biopsy was done and revealed a poorly differentiated synovial sarcoma pT2b, G3. Crural amputation was subsequently performed. Osseous invasion by synovial sarcomas of this extent is rarely reported.
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