Sahoo Tapan Kumar, Dhal Ipsita, Das Saroj Kumar, Majumdar Saroj Kumar Das, Parida Dillip Kumar
Senior Resident, Department of Radiotherapy, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India.
Senior Resident, Department of Pathology, Lady Hardinge Medical College and Associated Hospital, New Delhi, India.
J Clin Diagn Res. 2017 Jul;11(7):XD09-XD11. doi: 10.7860/JCDR/2017/25930.10212. Epub 2017 Jul 1.
Synovial sarcomas of the hand are extremely rare entities than most soft tissue sarcomas. The location at finger is further rarer than carpus of the hand. Synovial sarcoma of the hand/finger initially confused with many diagnoses such as myositis, haematoma, synovitis, tendonitis, bursitis, and other inflammatory lesions and therefore needs careful handling of the case with proper evaluation. We report a case of synovial sarcoma of the palmar surface of the right hand at interface of thumb and index finger in a 22-year-old female. The case was initially misdiagnosed as an abscess/haematoma of the finger 10 years back and treated with wide local excision. Synovial sarcoma was diagnosed on microscopic examination of excised specimen. Patient developed recurrent lesion twice locally. During first recurrence, the patient was treated with wide excision followed by radiotherapy and chemotherapy. Second recurrence was with bony destruction at the same site and below elbow amputation was performed.
手部滑膜肉瘤比大多数软组织肉瘤更为罕见。位于手指部位的滑膜肉瘤比手部腕骨处的更为罕见。手部/手指的滑膜肉瘤最初常被误诊为多种疾病,如肌炎、血肿、滑膜炎、腱鞘炎、滑囊炎及其他炎性病变,因此需要对病例进行仔细处理并进行恰当评估。我们报告一例22岁女性患者,其右手拇指与示指交界处掌面发生滑膜肉瘤。该病例10年前最初被误诊为手指脓肿/血肿,并接受了广泛局部切除治疗。经对切除标本进行显微镜检查后诊断为滑膜肉瘤。患者局部复发两次。首次复发时,患者接受了广泛切除,随后进行放疗和化疗。第二次复发时,同一部位出现骨质破坏,遂行肘部以下截肢手术。