A case of synovial sarcoma of the right mid-thigh and literature review

Figures

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  FIGURE 1. Ultrasound: (A) Slightly hypoechoic mass within the vastus medialis muscle of the right middle and lower thigh, with irregular morphology, poorly defined borders, and poorly homogeneous internal echogenicity. (B) Color Doppler: richer blood flow signals were seen within the mass.

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  FIGURE 2. MRI: A soft-tissue mass of the medial muscle of the right mid-thigh, which was lobulated and showed a “Triple-sign” of mixed high and low signals on T2-weighted images. (A) Speckled high signal is seen within the lesion, suggesting a localized cystic lesion, and the lesion encircles the superficial femoral artery. (B) Fibrous components and old hemorrhages in the lesion show low signal.

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  FIGURE 3. X-ray radiographic contrast:Irregular more massive tumor vascular shadows are seen in the soft tissue area of the right mid-femoral femur, supplied by the right superficial femoral artery and branches of the deep femoral artery, and dense tumor staining is seen in the parenchymal stage. (A) Front view. (B) Side view.

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  FIGURE 4. (A) The patient’s chest CT at the time of initial diagnosis did not reveal a definite metastatic lesion; (B) The patient’s follow-up chest CT 13 months after surgery showed the appearance of a new paravascular soft tissue nodule, and lung metastasis was considered.

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  FIGURE 5. (A) The tumor cells are densely proliferated, with flaky, nested mass, striated distribution, infiltrative growth, the nuclei are ovoid, fat pike-shaped, with visible nucleoli, and the nuclear schizophrenia is easy to be seen (hematoxylin and eosin staining; magnification, ×400). Visible characteristic cleft-like space (arrow). (B) Positive fluorescence in situ hybridization (FISH) analysis of the SYT (SS18) gene rearrangement.