Synovial sarcoma: A radiologic case report

Fig. 1. (A and B) Coronal T1 Precontrast and postcontrast images at the level of the mid thigh demonstrate a T1 isointense heterogeneously enhancing mass within the medial adductor compartment. (C) T2 Coronal fat-suppressed images at the level of the quadriceps demonstrate a solid mass with a cystic component (red arrows). (D) Axial T2 images at the level of the mid-thigh again show cystic components (red arrows) as well as fluid-fluid levels (green arrows) and partial encasement of the femoral vessels (magenta arrow).

Fig. 2. (A) Axial CTA images at the level of the mid-thigh show partial encasement of the femoral artery (magenta arrow) by the cystic mass. (B) Ultrasound Color Doppler images at the level of the mid thigh demonstrate a heterogeneous mass with internal vascularity, internal hypoechoic regions representing cystic spaces (red arrow) and partial encasement of the femoral artery (magenta arrow). (C) Contrast enhanced ultrasound precontrast images at the level of the mid thigh show a heterogeneously hypoechoic mass. (D) Contrast enhanced maximal enhancement postcontrast images at the level of the mid thigh show early internal and septal enhancement (yellow arrow) and areas of nonenhancement corresponding with cystic areas. Not shown was brisk enhancement and rapid washout was also observed.

Fig. 3. Hematoxylin and eosin stain of surgically resected right thigh mass at 100 times magnification (A) shows monotonous spindle cells and minimal stroma. Note staghorn vessel in the center of the image (red arrow) and lack of glandular architecture. Hematoxylin and eosin staining of surgically resection right thigh mass at 400 times magnification (B) shows closed packed ovoid and spindled nuclei (white arrow) with dispersed chromatin and prominent mitotic activity (yellow arrows).