A flap graft technique for the reconstruction of extensor mechanism of the knee in a case of peri-articular synovial sarcoma managed by limb salvage
Keywords:Synovial sarcoma, Extensor mechanism reconstruction, Mis-diagnosed synovial sarcoma, , Numerical pain rating scale (NPRS), Limb salvage
Synovial sarcoma is a malignant soft tissue tumour arising from the primitive mesenchymal cells which has a delayed progression has a slow progression and often mis-diagnosed. A fifty-two years old female presented with complaint of swelling, pain and inability to move her left knee for three years duration. Presented with recurrence for which Wide excision of the tumour, with reconstruction of knee using custom mega-prosthesis and extensor mechanism reconstruction was done. Patient had a good functional outcome and no recurrence.
Toro JR, Travis LB, Wu HJ, Zhu K, Fletcher CD, Devesa SS. Incidence patterns of soft tissue sarcomas, regardless of primary site, in the surveillance, epidemiology and end results program, 1978-2001: an analysis of 26,758 cases. Int J Cancer. 2006;119(12):2922-30.
Mastrangelo G, Coindre JM, Ducimetière F, Dei Tos AP, Fadda E, Blay JY, et al. Incidence of soft tissue sarcoma and beyond: a population‐based prospective study in 3 European regions. Cancer. 2012;118(21):5339-48.
WHO Classification of Tumours Editorial Board, 2020. WHO classification of tumours: soft tissue and bone tumours. International Agency for Research on Cancer. 2020. Available at: https://publications.iarc. fr/Book-And-Report-Series/Who-Classification-Of-Tumours/Soft-Tissue-And-Bone-Tumours-2020. Accessed on 2 November 2022.
Aytekin MN, Öztürk R, Amer K, Yapar A. Epidemiology, incidence, and survival of synovial sarcoma subtypes: SEER database analysis. J Orthop Surg. 2020;28(2):2309499020936009.
Jo VY, Fletcher CD. WHO classification of soft tissue tumours: an update based on the 2013 (4th) edition. Pathol. 2014;46(2):95-104.
Sultan I, Rodriguez‐Galindo C, Saab R, Yasir S, Casanova M, Ferrari A. Comparing children and adults with synovial sarcoma in the Surveillance, Epidemiology, and End Results program, 1983 to 2005: an analysis of 1268 patients. Cancer: Interdisciplinary. Int J Am Cancer Society. 2009;115(15):3537-47.
Smolle MA, Parry M, Jeys L, Abudu S, Grimer R. Synovial sarcoma: do children do better? Eur J Surgical Oncol. 2019;45(2):254-60.
Chotel F, Unnithan A, Chandrasekar CR, Parot R, Jeys L, Grimer RJ. Variability in the presentation of synovial sarcoma in children: a plea for greater awareness. J Bone Joint Surg. 2008;90(8):1090-6.
De Silva MV, Barrett A, Reid R. Premonitory pain preceding swelling: a distinctive clinical presentation of synovial sarcoma which may prompt early detection. Sarcoma. 2003;7(3-4):131-5.
Bakri A, Shinagare AB, Krajewski KM, Howard SA, Jagannathan JP, Hornick JL, et al. Synovial sarcoma: imaging features of common and uncommon primary sites, metastatic patterns, and treatment response. Am J Roentgenol. 2012;199(2):W208-15.
Bixby SD, Hettmer S, Taylor GA, Voss SD. Synovial sarcoma in children: imaging features and common benign mimics. Am J Roentgenol. 2010;195(4):1026-32.
Kao SC. Overview of the clinical and imaging features of the most common non-rhabdomyosarcoma soft-tissue sarcomas. Pediatric Radiol. 2019;49(11):1524-33.
O'sullivan PJ, Harris AC, Munk PL. Radiological features of synovial cell sarcoma. Bri J Radiol. 2008;81(964):346-56.
Von Mehren M, Randall RL, Benjamin RS, Boles S, Bui MM, Conrad EU, et al. Soft tissue sarcoma, version 2.2016, NCCN clinical practice guidelines in oncology. J National Comprehensive Cancer Network. 2016;14(6):758-86.
Ghert MA, Abudu A, Driver N, Davis AM, Griffin AM, Pearce D, et al. The indications for and the prognostic significance of amputation as the primary surgical procedure for localized soft tissue sarcoma of the extremity. Ann Surgical Oncol. 2005;12:10-17.
Guadagnolo BA, Zagars GK, Ballo MT, Patel SR, Lewis VO, Pisters PW, et al. Long-term outcomes for synovial sarcoma treated with conservation surgery and radiotherapy. Int J Radiation Oncol Biol Physics. 2017;69(4):1173-80.
Kawaguchi N, Ahmed AR, Matsumoto S, Manabe J, Matsushita Y. The concept of curative margin in surgery for bone and soft tissue sarcoma. Clinical Orthopaedics and Related Research (1976-2007). 2004;419:165-72.
Gazendam AM, Popovic S, Munir S, Parasu N, Wilson D, Ghert M. Synovial sarcoma: a clinical review. Curr Oncol. 2021;28(3):1909-20.