Clear Cell Sarcoma: A Rare Aggressive Tumor with Potential Diagnostic Challenge

Original Article | Volume 6 | Issue 2 | JBST May-August 2020 | Page 9-11 | Adam Goldman, Matthew Doscher, Neil Lancaster, Paul Lamberti. DOI: 10.13107/jbst.2020.v06i02.24

Author: Adam Goldman[1], Matthew Doscher[1], Neil Lancaster[2], Paul Lamberti[1]

[1]Department of Orthopaedics, John H. Stroger, Jr. Hospital of Cook County, Chicago, Illinois, USA,
[2]Department of Orthopaedics, Franciscan Health- Olympia Fields, Illinois, USA.

Address of Correspondence
Dr. Adam Goldman,
Orthopedic Surgery Resident, Franciscan Health Olympia Fields
20201 S. Crawford Ave, Olympia Fields, IL 60461.


Introduction: Synovial sarcomas of the hand are extremely rare, high grade, slow growing, malignant soft-tissue neoplasms. They represent only a fraction of soft-tissue sarcomas, are usually found in the lower extremities around tendon sheaths, bursae, and joint capsules, and carry a significant risk for recurrence and eventual metastasis to the lymph nodes and lungs. There are limited reports of synovial sarcomas of the hand.
Case Report: A 67-year-old male presented with a slow-growing soft-tissue mass of the proximal right long finger over the course of one year. Initial excision was performed, which provided a diagnosis of monophasic synovial cell sarcoma. Subsequently, the patient underwent further staging with an eventual ray resection of the right long finger and an index ray transfer.
Conclusion: There are unique approaches to a patient with a highly malignant neoplasm in the hand. By performing a ray resection and index ray transfer, the patient was spared the potential side effects of radiation therapy and provided a quality functional and cosmetic outcome. The patient returned to work 4 weeks postoperatively. To the best of our knowledge, this treatment has not been used for a synovial sarcoma of the hand.
Keywords: Hand, synovial sarcoma, soft-tissue sarcoma, soft-tissue neoplasms

1. Siegel HJ, Sessions W, Casillas MA Jr., Said-Al-Naief N, Lander PH, Lopez-Ben R. Synovial sarcoma: Clinicopathologic features, treatment, and prognosis. Orthopedics 2007;30:1020-7.
2. Rosa AC, Machado MM, Filho LEG, Albertotti F, Sato E, Figueiredo MAJ et al. Sarcoma sinovial fibroso do pe: Relato de caso. Radiol Bras 2002;35:51-4.
3. Michal M, Fanburg-Smith JC, Lasota J, Fetsch JF, Lichy J, Miettinen M. Minute synovial sarcomas of the hands and feet: A clinicopathologic study of 21 tumors less than 1 cm. Am J Surg Pathol 2006;30:721-6.
4. Okcu MF, Munsell M, Treuner J, Mattke A, Pappo A, Cain A, et al. Synovial sarcoma of childhood and adolescence: A multicenter, multivariate analysis of outcome. J Clin Oncol 2003;21:1602-11.
5. Pradhan A, Cheung YC, Grimer RJ, Peake D, Al-Muderis OA, Thomas JM, et al. Soft-tissue sarcomas of the hand: Oncological outcome and prognostic factors. J Bone Joint Surg Br 2008;90:209-14.
6. Outani H, Hamada K, Oshima K, Joyama S, Naka N, Araki N, et al. Clinical outcomes for patients with synovial sarcoma of the hand. Springerplus 2014;3:649.
7. Sahoo TK, Dhal I, Das SK, Majumdar SK, Parida DK. Synovial sarcoma of palmar aspect of hand and survival: A rare case report. J Clin Diagn Res 2017;11:XD9-11.
8. Eilber FC, Dry SM. Diagnosis and management of synovial sarcoma. J Surg Oncol 2008;97:314‐20.
9. Italiano A, Penel N, Robin YM, Bui B, Le Cesne A, Piperno-Neumann S, et al. Neo/adjuvant chemotherapy does not improve outcome in resected primary synovial sarcoma: A study of the French sarcoma group. Ann Oncol 2009;20:425-30.
10. Maia DC, Menezes CK, Bastos TC, de Lima Ferreira LC, Francesconi F. Poorly differentiated synovial sarcoma in the wrist: Case report. An Bras Dermatol 2014;89:816-18.
11. Puhaindrain ME, Healy JH, Athanasian EA. Single ray amputations for tumors of the hand. Clin Orthop Relat Res 2010;468:1390-5.

How to Cite this article: Goldman A, Doscher M, Lancaster N, Lamberti P | Clear Cell Sarcoma: A Rare Aggressive Tumor with Potential Diagnostic Challenge | Journal of Bone and Soft Tissue Tumors | May-August 2020; 6(2): 9-11.

[Full Text HTML] [Full Text PDF] [XML]