Question
A 30-year-old male presents with a deep thigh mass that he notes has been present for several years. A biopsy section is shown here. What is the diagnosis?
A. Osteosarcoma.
B. Liposarcoma.
C. Nodular fasciitis.
D. Synovial sarcoma.
Show Answer
|
Correct Answer » D
Explanation
|
|
The answer is D, synovial sarcoma.Histologically, synovial sarcomas may be biphasic, monophasic, or poorly differentiated. The tumor in this particular case is a biphasic synovial sarcoma – it’s composed of spindle cells and epithelial cells. Monophasic tumors can be spindle-cell or epithelial, but they are usually composed of just the spindle cell component.
Synovial sarcomas grow slowly. In fact, many patients describe a several-year history of a mass, which is what you’d expect with a benign tumor. However, synovial sarcoma is aggressive and persistent. Treatment usually involves surgery and chemotherapy, but local recurrence and metastasis are very common. The prognosis is poor, with a 5-year survival between 40-70%.
