Summary
Synovial sarcoma is the most common malignant soft tissue sarcoma in the foot, accounting for 18-22% of all such tumors. (9) In some series it is the single most common sarcoma of any type in the distal lower extremity.
Complete Information on this Tumor
Synovial sarcoma is the most common malignant soft tissue sarcoma in the foot, accounting for 18-22% of all such tumors. (9) In some series it is the single most common sarcoma of any type in the distal lower extremity. This tumor deserves extra attention and study for several reasons. Among these are this tumor's potential for slow, painless growth, its peak incidence in young patients, and the serious consequences of delay in diagnosis.The most common location is the leg, ankle, or foot. The lesion is usually deeply seated, firm, and painless, but small superficial lesions are also seen. The tumor is firm to exam and does not transilluminate. Metastasis may occur to regional lymph nodes and these should be included in the physical examination.
The presentation of synovial sarcoma is variable and may mimic a benign process such as ganglion cyst. The patient may have a mass that has been present for months, years, or even decades, with slow growth and little or no symptoms. There may have been recent rapid growth of a lesion that has been present for years without apparent change. Conversely, some of these sarcomas may be very painful from the outset. The average duration of symptoms before diagnosis is 21 months.
On light microscopy, synovial sarcomas may be monophasic fibrous and biphasic. The monophasic type may appear to be a mass of small round blue cells, or more fibrous with spindle shaped cells. The biphasic type is of fibrous areas with clefts or spaces or areas with epithelial cells.