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Synovial sarcoma - knee

Case contributed by Maulik S Patel
Diagnosis almost certain

Presentation

C/o knee pain. Nodule antero-lateral aspect of left knee.

Patient Data

Age: about 40 yrs
Gender: Female

Referred with MR of knee...

ultrasound

Referred with MR of knee showing Low T1 SI High T2 SI lesion abutting iliotibial band. Presumed ganglion cyst.

A well-defined but irregular shaped lesion is noted abutting distal end of ilio-tibial band. It looks anechoic in first two images, hypoechoic in last two images. Single flow signal in peripheral part of the lesion is noted.

Follow up 2 mths later.

ultrasound

Hypoechoic lesion with definite vascularity.

Case Discussion

Findings of an extra-articular lesion abutting ilio-tibial band.

1st USG ( done by me ) reported a gaglion cyst - may be complex one with flow in periphery and hypoechoic in few planes.

2nd USG ( done by me ) - looked definitely solid lesion with vascularity. 1st USG images were reviewed and i felt it was an obvious solid lesion at that time also. So it was a misdiagnosis during 1st scan.

Surgical excision done.

Histopathology - Synovial sarcoma.

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