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Synovial Sarcoma of the Hand
Hovsep Ohan1, Greg Minassian2, Asaad H Samra3
1Department of Pathology, Anatomy and Laboratory Medicine (PALM), Robert C. Byrd Health Sciences Center, West Virginia University School of Medicine, Morgantown, West Virginia, USA.
Case Reports in Pathology
|June 23, 2020
Summary
Synovial sarcoma of the palm is exceptionally rare. This case report highlights a monophasic synovial sarcoma in a 34-year-old male, emphasizing the need for early diagnosis of unusual hand masses.
Area of Science:
- Orthopedic Oncology
- Surgical Pathology
Background:
- Synovial sarcoma, a rare soft tissue malignancy, typically affects the extremities.
- Palmar localization of synovial sarcoma is exceedingly uncommon, with an incidence of 1.548 per 1,000,000.
Observation:
- A 34-year-old male presented with a slowly growing mass on the palmar aspect of his right hand, extending from the mid-third metacarpal to involve multiple digits.
- Histopathologic examination confirmed monophasic synovial sarcoma.
- Fluorescence in situ hybridization revealed SYT gene rearrangement in 72% of the tumor cells.
Findings:
- Surgical resection followed by adjuvant radiation and chemotherapy was performed.
- The patient achieved a 3.5-year disease-free survival with no local recurrence.
- This case underscores the successful management of an extremely rare presentation of synovial sarcoma.
Implications:
- Increased awareness of rare hand malignancies like palmar synovial sarcoma is crucial for timely diagnosis.
- Synovial sarcoma should be considered in the differential diagnosis of persistent, slow-growing hand lesions, regardless of patient age.
- Early detection and comprehensive treatment can lead to improved patient outcomes for this rare tumor.
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