Synovial sarcoma

Case contributed by Dr Hani Salam

Presentation

Right thigh swelling.

Patient Data

Age: 35
Gender: Female
X-ray

X-rays

Rounded but ill-defined soft tissue swelling is located posteromedial to the femur. There is evidence of cortical erosion which appears to have a relatively wide zone of transition. The mass itself demonstrates no calcification. Incidental note is made of contrast in the bladder from preceding CT scan (not shown). 

MRI

MRI thigh

MRI of the thigh confirms the presence of a large heterogeneous mass extending into all compartments. It enhances brightly but irregularly with areas of presumed necrosis. Erosion of the femur is also shown without however evidence of extension into the bone marrow on axial images. There is extensive oedema extending proximal and distal to the mass. 

Nuclear medicine

Bone scan

Bone scan demonstrates elevation of activity on both dynamic and blood pool views. Bone phase shows only minor local increase (not shown). 

Case Discussion

Although synovial sarcomas are a relatively uncommon soft tissue sarcoma, they tend to affect younger patients and have a poor prognosis. They are difficult to distinguish from other sarcomas on imaging. 

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Case information

rID: 7809
Case created: 10th Dec 2009
Last edited: 26th Nov 2015
Inclusion in quiz mode: Included

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