Abstract
We report a case of a 75-year-old man with synovial sarcoma.There was a painful mass, 3.5×3×2cm in size, on the dorsum of the DIP joint of his left thumb. The mass was smooth on the surface, relatively well-demarcated, elastic soft, weak and hemorrhagic. There was osteolytic change in the phalanx of the thumb on X-ray.Histological examination revealed the tumor mainly consisted of hypercellular sheets of small round cells with dark-stained nuclei. Another portion of the specimen showed presence of a typical biphasic pattern, which was composed of epitheloid cells and spindle cells. Immunohistochemically, the small round cells and spindle cells were positive for vimentin, and the epitheloid cells were positive for CAM 5.2. These cells were negative for CEA, S-100 protein, HMB-45 and CD34. The tumor was diagnosed as poorly differentiated synovial sarcoma. Chest X-ray and CT showed a giant mass in the upper lobe of the right lung. We couldn't obtain a biopsy specimen of the mass because of severe hemoptysis during the bronchoscopic examination. We assumed that the tumor was lung metastasis of synovial sarcoma.The patient's left thumb was amputated. Radiotherapy for the lung mass was not effective. He died of respiratory failure 6 months after the tumor of the left thumb appeared. [Skin Cancer (Japan) 2002; 17: 70-74]
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