Inguinal swelling unveiling biphasic synovial sarcoma: A case report

INTRODUCTION AND IMPORTANCE: Synovial sarcoma is a high-grade soft tissue sarcoma primarily affecting teenagers and young adults. Inguinal region involvement is rare, making diagnosis and treatment challenging. CASE PRESENTATION: A 35-year-old Tunisian man presented with a progressively enlarging right inguinal swelling. Imaging revealed a mass behind the inguinal ligament, confirmed as biphasic synovial sarcoma through biopsy. The patient underwent successful surgery with clear resection margins. Histopathological examination revealed a biphasic sarcoma with spindle cell and glandular components, supporting the diagnosis of synovial sarcoma. Following surgery, the patient received adjuvant radiotherapy. Regular outpatient follow-up is being conducted to monitor progress. CLINICAL DISCUSSION: Synovial sarcoma is characterized by slow growth and local invasiveness, with potential for metastasis. It typically presents as a solid mass that can compress nearby structures such as blood vessels. Imaging studies offer valuable insights into tumor location, size, invasiveness, and potential metastases. Local tumor staging relies on MRI, while distant metastases are detected using chest CT or bone scans. Diagnosis is confirmed through histopathological examination and immunohistochemical analysis. CONCLUSIONS: This case report highlights a rare presentation of inguinal synovial sarcoma and emphasizes the importance of individualized multimodal therapy in its management.