PMC7293724_01
T1-weighted coronal and sagittal MRI revealing a large, lobulated, soft tissue lesion with aggressive features located on the ventral surface of the hand and extending from the mid-third digit to the fifth digit. (a) Coronal view demonstrating a hypointense enhancing lobular lesion at the third ray. (b) Sagittal view showing a soft tissue lesion surrounding the flexor tendons and extending into the interspace between the head of the third and fourth metacarpals.
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fig1
Magnetic resonance imaging, performed with contrast, demonstrated a large lobulated enhancing lesion measuring 4.7 cm in its greatest dimension (Figure 1).
Histologic evaluation of a hand tumor indicative of monophasic synovial sarcoma. (a) At low power magnification, a well-circumscribed hypercellular mass with areas of fibrosis and high vascularity can be seen. (b) The monophasic synovial sarcoma shows a densely packed, interlacing spindled cell proliferation with monomorphic cells arranged in a myxoid stroma. The nuclei are ovoid and pale-staining with small nucleoli. Rich vascularity is present. (c) High-magnification revealing mitotic figures.
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fig2
Occasional mitotic figures were identified (Figure 2). Accordingly, the tumor was classified as a monophasic synovial sarcoma (Figure 2).