Hind-Foot Synovial Sarcoma Treated With Wide Resection and Sural Fasciocutaneous Flap – A Case Report

João Vale

doi:10.47363/jonrr/2021(2)152

Abstract

Synovial sarcoma comprises about 5% to 10% of soft tissue sarcomas. Initial growth is often slow and a small circumscribed tumour may misleadingly appear to a benign lesion by clinical examination and imaging, occurring in up to 50% of cases. The modalities of treatment of foot malignant conditions depend on histological diagnosis and staging. A radical surgical procedure in the distal region of the lower limb is often difficult due to a limited soft-tissue situation and can result in soft-tissue defects. Plastic surgical techniques remain particularly indispensable in the treatment of such distal tumors. Authors present a hindfoot synovial sarcoma, diagnosed with a incisional biopsy, in which a wide margin surgery was achieved and a limb salvage was permitted by a sural fasciocutaneous flap.

Highlights

Soft-tissue sarcomas are rare tumours of mesenchymal origin, and are 1% of all adult malignancies
Authors present a hindfoot synovial sarcoma, diagnosed with a incisional biopsy, in which a wide margin surgery was achieved and a limb salvage was permitted by a sural fasciocutaneous flap
Synovial sarcoma (SS) is a malignant mesenchymal neoplasm with partial epithelial differentiation, that occurs predominantly in older children and young adults and that has been shown to occur at almost any anatomic site, comprising about 5% to 10% of soft tissue sarcomas [2,3]

Summary

Introduction

Soft-tissue sarcomas are rare tumours of mesenchymal origin, and are 1% of all adult malignancies. Synovial sarcoma (SS) is a malignant mesenchymal neoplasm with partial epithelial differentiation, that occurs predominantly in older children and young adults and that has been shown to occur at almost any anatomic site, comprising about 5% to 10% of soft tissue sarcomas [2,3]. Attainment of clear margins becomes much more difficult in tumour of extremities and can result in soft-tissue defects. Authors present a hindfoot synovial sarcoma in which a wide margin surgery was achieved and a limb salvage was permitted by a sural fasciocutaneous flap. One month after surgery the patient was submitted to adjuvant RT in the right calcaneus

Discussion

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Conclusion