Boc Steven F, Das-Wattley Sharmila, Roberts Eric
Hahnemann University Hospital, Drexel University College of Medicine, Hahnemann University Hospital, Philadelphia, PA 19107, USA.
J Foot Ankle Surg. 2011 Jan-Feb;50(1):117-21. doi: 10.1053/j.jfas.2010.10.010.
Synovial sarcomas occur primarily in the soft tissue structures adjacent to the joints and tendons of the extremities. A diagnostic dilemma exists when the clinical presentation is similar to that of an infection or soft tissue trauma. We report a case of soft tissue sarcoma of the foot in a previously healthy 19-year-old male who presented after hitting his right foot against a refrigerator. Initial radiographs were negative; however, 6 weeks later plain radiographs revealed destruction of the metatarsals. Histologic analysis on a specimen obtained via fine-needle aspiration confirmed the diagnosis of primary synovial sarcoma. Further workup revealed metastases to the lungs. An amputation at Chopart's joint was performed. Primary synovial sarcoma in the foot can mimic infection or edema from a traumatic event. Clinicians should always be suspicious of soft tissue masses and keep neoplastic processes in the list of differentials.
滑膜肉瘤主要发生于四肢关节和肌腱附近的软组织结构。当临床表现与感染或软组织创伤相似时,就会存在诊断难题。我们报告一例足部软组织肉瘤病例,患者为一名19岁既往健康男性,因右脚踢到冰箱后前来就诊。最初的X线片结果为阴性;然而,6周后普通X线片显示跖骨破坏。经细针穿刺获取的标本进行组织学分析确诊为原发性滑膜肉瘤。进一步检查发现肺部转移。遂行Chopart关节截肢术。足部原发性滑膜肉瘤可酷似创伤性事件引起的感染或水肿。临床医生应始终对软组织肿块保持怀疑,并将肿瘤性病变列入鉴别诊断清单。