48 Synovial Sarcoma

CASE 48


Synovial Sarcoma


George Nomikos, Anthony G. Ryan, Peter L. Munk, Mark Murphey


Clinical Presentation


A 23-year-old man presented with intermittent aching in the left shoulder following a sports injury 1½ years prior to his visit to the hospital.



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Figure 48A



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Figure 48B



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Figure 48C


Radiographic Findings


The axial T1-weighted image (Fig. 48A) shows a soft-tissue mass around the proximal humerus. The mass is isointense to muscle. Note the focal area of marrow replacement in the humeral head compatible with osseous invasion. The mass is heterogeneously high signal intensity on the axial T2-weighted image (Fig. 48B) with no significant surrounding edema. Also note the fluid levels in the mass resulting from internal hemorrhage. The postcontrast T1-weighted image (Fig. 48C) demonstrates diffuse enhancement of the solid portion of the mass and peripheral enhancement of the cystic/hemorrhagic portion. The focal area of osseous invasion is also well illustrated on this coronal image.


Diagnosis


Synovial sarcoma.


Differential Diagnosis



  • Malignant fibrous histiocytoma/fibrosarcoma
  • Malignant peripheral nerve sheath tumor (MPNST)
  • Leiomyosarcoma
  • Atypical infection

Discussion


Background

Feb 14, 2016 | Posted by in MUSCULOSKELETAL IMAGING | Comments Off on 48 Synovial Sarcoma
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