A Tumour in Disguise in the Right Palm- Monophasic Synovial SarcomaCorrespondence Address :
Dr. Sandhya Sundaram,
2A, Abirami Meaddowland, 32 Park Road, Anna Nagar West, Padi, Chennai-600050, India.
Synovial sarcoma is one of the poorly differentiated malignant soft tissue tumour occuring commonly among young adults in the extremities. We report a 50-year-old female presenting with a soft tissue mass in the right palm. On examination, a single firm and non tender swelling was noticed adjacent to the thenar muscles. Radiology suggested a benign soft tissue lesion. The swelling, clinically thought to be a lipoma, was excised and sent for histopathological examination. Microscopy showed a highly cellular tumour arranged in nests, cords and pseudo glandular pattern separated by dense fibrocollagenous tissue. An interesting and baffling finding was the presence of a distinct mucin vacuole in many of the tumour cells. A diagnosis of soft tissue sarcoma with epithelial features was considered and a panel of immunohistochemical stains done. Tumour cells showed strong positivity for cytokeratin 7, vimentin, EMA & Bcl2. CD 99 and S100 were focally positive. CD 34 and CEA were negative. In view of the above microscopic and immunohistochemical findings, a diagnosis of monophasic synovial sarcoma of epithelial type was rendered. This case is being documented for the rare morphological appearance of mucin vacuoles in a monophasic epithelial type synovial sarcoma.
Epithelial type, Malignant soft tissue tumour, Mucin vacuoles
Vasugi Gramani Arumugam, Sandhya Sundaram, Anita Ramesh, Prathiba Duvuru, Srinivasa Rajappa. A TUMOUR IN DISGUISE IN THE RIGHT PALM- MONOPHASIC SYNOVIAL SARCOMA. Journal of Clinical and Diagnostic Research [serial online] 2016 May [cited: 2018 Mar 18 ]; 10:ED03-ED05. Available from
Date of Submission: Sep 04, 2014
Date of Peer Review: Jul 20, 2015
Date of Acceptance: Mar 14, 2016
Date of Publishing: May 01, 2016
Financial OR OTHER COMPETING INTERESTS: None.
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