CASE REPORT article
Front. Oncol.
Sec. Cancer Imaging and Image-directed Interventions
Volume 15 - 2025 | doi: 10.3389/fonc.2025.1615945
This article is part of the Research TopicAdvances in Limb-Salvage Surgery and Reconstruction for Pediatric Bone and Soft Tissue TumorsView all articles
Diagnostic Pitfalls in Soft Tissue Tumors: Synovial Sarcoma Masquerading as Venous Malformation
Provisionally accepted
- School of Medicine, Shanghai Jiao Tong University, Shanghai, China
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Introduction: Synovial 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 presentation: An 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. Conclusion: SS 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.
Keywords: synovial sarcoma, Intramuscular venous malformation, MRI, pathological examination Diagnostic Pitfalls in Soft Tissue Tumors: Synovial Sarcoma Masquerading as Venous Malformation, SS18
Received: 23 Apr 2025; Accepted: 29 Jul 2025.
Copyright: © 2025 Jiang, Hu, Chen, Yang and Lin. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Xi Yang, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
Xiaoxi Lin, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
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