Synovial Sarcoma Arising From the Falciform Ligament

Synovial sarcoma is a rare soft tissue malignancy that is most commonly found in the extremities of adolescents and young adults. Despite accounting for a small percentage of all soft tissue sarcomas, its aggressive behaviour makes early recognition and management crucial. We present the rare case of a 64-year-old man with a large epigastric mass extending into the mediastinum and involving the pericardium, which was found to be a synovial sarcoma arising from the falciform ligament. The tumour was locally invading the liver and anterior mediastinum and was associated with pulmonary metastases. Despite treatment with neoadjuvant chemotherapy, the tumour demonstrated only a partial response at the primary site and progression of metastatic disease, precluding surgical resection.