Case Report: Diagnostic pitfalls in soft tissue tumors: synovial sarcoma masquerading as venous malformation
IntroductionSynovial sarcoma (SS) is one of the most prevalent malignant soft tissue sarcomas in children and adolescents. Pediatric populations often present with atypical features, complicating the differentiation from benign intramuscular venous malformations (VMs).Case presentationAn 11-year-o...
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Frontiers Media S.A.
2025-08-01
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| Series: | Frontiers in Oncology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fonc.2025.1615945/full |
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| author | Xuan Jiang Li Hu Hui Chen Xi Yang Xiaoxi Lin Xiaoxi Lin |
| author_facet | Xuan Jiang Li Hu Hui Chen Xi Yang Xiaoxi Lin Xiaoxi Lin |
| author_sort | Xuan Jiang |
| collection | DOAJ |
| description | IntroductionSynovial sarcoma (SS) is one of the most prevalent malignant soft tissue sarcomas in children and adolescents. Pediatric populations often present with atypical features, complicating the differentiation from benign intramuscular venous malformations (VMs).Case presentationAn 11-year-old male with a four-year history of progressive right plantar pain and a compressible intramuscular mass. The initial magnetic resonance imaging (MRI) findings suggest VM, due to high signal in T2-weighted images. Sclerotherapy under digital subtraction angiography (DSA) revealed unexpected hyper-vascularity, prompting surgical exploration. Histopathology demonstrated spindle and epithelioid cells with hemangiopericytoma-like morphology and mitotic activity, while SS18-SSX1 gene rearrangement confirmed SS. Chemotherapy was then administered, without recurrence over two years.ConclusionSS may clinically and radiographically mimic benign vascular anomalies, particularly in children. Discrepancies in vascular dynamics on DSA and atypical imaging features warrant suspicion for malignancy. Early histopathological validation is critical to prevent diagnostic delays, optimize multimodal therapy, and improve outcomes in this aggressive tumor. |
| format | Article |
| id | doaj-art-4006ee57e2db4b5c9bb273d6c6f9a48e |
| institution | Kabale University |
| issn | 2234-943X |
| language | English |
| publishDate | 2025-08-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Oncology |
| spelling | doaj-art-4006ee57e2db4b5c9bb273d6c6f9a48e2025-08-25T10:23:04ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2025-08-011510.3389/fonc.2025.16159451615945Case Report: Diagnostic pitfalls in soft tissue tumors: synovial sarcoma masquerading as venous malformationXuan Jiang0Li Hu1Hui Chen2Xi Yang3Xiaoxi Lin4Xiaoxi Lin5Department of Plastic and Reconstructive Surgery, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, ChinaDepartment of Plastic and Reconstructive Surgery, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, ChinaDepartment of Plastic and Reconstructive Surgery, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, ChinaDepartment of Plastic and Reconstructive Surgery, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, ChinaDepartment of Plastic and Reconstructive Surgery, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, ChinaDepartment of Laser and Aesthetic Medicine, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, ChinaIntroductionSynovial sarcoma (SS) is one of the most prevalent malignant soft tissue sarcomas in children and adolescents. Pediatric populations often present with atypical features, complicating the differentiation from benign intramuscular venous malformations (VMs).Case presentationAn 11-year-old male with a four-year history of progressive right plantar pain and a compressible intramuscular mass. The initial magnetic resonance imaging (MRI) findings suggest VM, due to high signal in T2-weighted images. Sclerotherapy under digital subtraction angiography (DSA) revealed unexpected hyper-vascularity, prompting surgical exploration. Histopathology demonstrated spindle and epithelioid cells with hemangiopericytoma-like morphology and mitotic activity, while SS18-SSX1 gene rearrangement confirmed SS. Chemotherapy was then administered, without recurrence over two years.ConclusionSS may clinically and radiographically mimic benign vascular anomalies, particularly in children. Discrepancies in vascular dynamics on DSA and atypical imaging features warrant suspicion for malignancy. Early histopathological validation is critical to prevent diagnostic delays, optimize multimodal therapy, and improve outcomes in this aggressive tumor.https://www.frontiersin.org/articles/10.3389/fonc.2025.1615945/fullsynovial sarcomaintramuscular venous malformationMRIpathological examinationSS18 |
| spellingShingle | Xuan Jiang Li Hu Hui Chen Xi Yang Xiaoxi Lin Xiaoxi Lin Case Report: Diagnostic pitfalls in soft tissue tumors: synovial sarcoma masquerading as venous malformation Frontiers in Oncology synovial sarcoma intramuscular venous malformation MRI pathological examination SS18 |
| title | Case Report: Diagnostic pitfalls in soft tissue tumors: synovial sarcoma masquerading as venous malformation |
| title_full | Case Report: Diagnostic pitfalls in soft tissue tumors: synovial sarcoma masquerading as venous malformation |
| title_fullStr | Case Report: Diagnostic pitfalls in soft tissue tumors: synovial sarcoma masquerading as venous malformation |
| title_full_unstemmed | Case Report: Diagnostic pitfalls in soft tissue tumors: synovial sarcoma masquerading as venous malformation |
| title_short | Case Report: Diagnostic pitfalls in soft tissue tumors: synovial sarcoma masquerading as venous malformation |
| title_sort | case report diagnostic pitfalls in soft tissue tumors synovial sarcoma masquerading as venous malformation |
| topic | synovial sarcoma intramuscular venous malformation MRI pathological examination SS18 |
| url | https://www.frontiersin.org/articles/10.3389/fonc.2025.1615945/full |
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