Synovial sarcoma with medullary invasion
Abstract
Introduction: synovial sarcoma is a malignant neoplasm of mesenchymal origin, composed of spindle cells and a component of epithelial differentiation with varying degrees of dysplasia. It mainly affects the extremities, with predominance of the lower ones. Of the soft tissue sarcomas 5-10 % are synovial.
Objective: to present the case of a patient with synovial sarcoma from the imaging findings that made it possible to diagnose the disease.
Case presentation: female patient, 38 years old, with health history. She presented a painful picture in the distal region of the thigh, of 12 months of evolution, with increased volume and aggravation of symptoms in the last five months. Physical examination revealed changes in the texture of the skin of the right knee, moderate volume increase, and pain on palpation more pronounced in the distal region of the thigh, with limited movement. Nuclear magnetic resonance of the right thigh with intravenous contrast showed an extensive mass of heterogeneous appearance, enhanced with the administration of contrast medium (Dotarem) located predominantly in the distal third of the thigh, which invaded the medullary canal, associated with osteolysis and periostitis.
Conclusions: in the cases of patients with symptoms such as the one presented, the pertinent imaging studies should be carried out to confirm the diagnostic possibility of synovial sarcoma. Due to its characteristics, nuclear magnetic resonance is the imaging technique of choice to detect, characterize, stage and follow the evolution of these tumorsDownloads
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