Saito Keiju, Kawabata Yusuke, Kobayashi Naomi, Iwashita Hiromichi, Kato Ikuma, Otani Masako, Hayashida Kenta, Fujita Shintaro, Yoshida Tomotaka, Choe Hyonmin, Takeyama Masanobu, Inaba Yutaka
Department of Orthopaedic Surgery, Yokohama City University, Yokohama, Japan.
Department of Orthopaedic Surgery, Yokohama City University Medical Center, Yokohama, Japan.
J Surg Case Rep. 2023 Feb 27;2023(2):rjad066. doi: 10.1093/jscr/rjad066. eCollection 2023 Feb.
Although synovial sarcoma is a relatively common soft tissue sarcoma, primary intra-articular cases are extremely rare. Herein, we report a case of primary intra-articular synovial sarcoma arising from the hip joint, that was initially treated with hip arthroscopy. A 42-year-old male presented with a history of pain in the left hip for 7 years. Radiography and magnetic resonance imaging revealed the primary intra-articular lesion and simple excision with an arthroscopy was performed. Histological findings revealed spindle cell proliferation with abundant psammoma bodies. SS18 gene rearrangement was confirmed by fluorescence hybridization, and the tumor was diagnosed as synovial sarcoma. Adjuvant chemotherapy and radiotherapy were performed. Local control without metastasis was achieved 6 months after excision. This is the first case of intra-articular synovial sarcoma of the hip joint excised via hip arthroscopy. When an intra-articular lesion is identified, malignancies such as synovial sarcoma should be included in the differential diagnosis.
尽管滑膜肉瘤是一种相对常见的软组织肉瘤，但原发性关节内病例极为罕见。在此，我们报告一例起源于髋关节的原发性关节内滑膜肉瘤病例，该病例最初接受了髋关节镜检查治疗。一名42岁男性，有左髋部疼痛7年的病史。X线摄影和磁共振成像显示了原发性关节内病变，并通过关节镜进行了单纯切除。组织学检查发现梭形细胞增生并伴有大量砂粒体。通过荧光杂交证实了SS18基因重排，肿瘤被诊断为滑膜肉瘤。进行了辅助化疗和放疗。切除术后6个月实现了无转移的局部控制。这是首例通过髋关节镜切除的髋关节关节内滑膜肉瘤病例。当发现关节内病变时，滑膜肉瘤等恶性肿瘤应列入鉴别诊断范围。
