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Synovium as a widespread pathway to the adjacent joint in undifferentiated high-grade pleomorphic sarcoma of the tibia: A case report

RATIONALE: Undifferentiated high-grade pleomorphic sarcoma (UPS), originated from bone, is a rare tumor, accounting for 2% to 5% of all primary maligment bone neoplasms. Skip lesion can be found in undifferentiated high-grade pleomorphic sarcoma of bone (UPS-B). However, the direct invasion across t...

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Autores principales: Li, Xiaona, Zhang, Zekun, Latif, Mahrukh, Chen, Wei, Cui, Jianling, Peng, Zhigang
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer Health 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5842000/
https://www.ncbi.nlm.nih.gov/pubmed/29465573
http://dx.doi.org/10.1097/MD.0000000000009870
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author Li, Xiaona
Zhang, Zekun
Latif, Mahrukh
Chen, Wei
Cui, Jianling
Peng, Zhigang
author_facet Li, Xiaona
Zhang, Zekun
Latif, Mahrukh
Chen, Wei
Cui, Jianling
Peng, Zhigang
author_sort Li, Xiaona
collection PubMed
description RATIONALE: Undifferentiated high-grade pleomorphic sarcoma (UPS), originated from bone, is a rare tumor, accounting for 2% to 5% of all primary maligment bone neoplasms. Skip lesion can be found in undifferentiated high-grade pleomorphic sarcoma of bone (UPS-B). However, the direct invasion across the articular synovium to bone has not been reported previously. PATIENT CONCERNS: We report an unusual case of a 65-year-old man complained of a year history of pain, swelling, and limitation of activity in the left knee joint. At the proximal tibia, there was extensive invasion of articular synovium, which provides a direct anatomic pathway for the tumor invasion to the adjacent bone, including patella and femoral condyle. DIAGNOSES: Magnetic resonance imaging was important in defining the marrow involvement and joint invasion, including the thickening articular synovium. Subsequent pathological examination confirmed the diagnosis of UPS. INTERVENTIONS: The patient underwent an extensive resection of the knee joint, except for the patellar. OUTCOMES: After operation, routine chemotherapy was performed. Unfortunately, half a year later, soft tissue swelling of whole thigh was found. Then this patient came our hospital again. Positron emission tomography imaging showed there was recurrence of UPS with lung metastasis. A week later, this patient died. LESSONS: In contrast to frequent infiltration pathway, the articular synovium as a media for this tumor spread is rare. This study adds a better understanding of this direct invasion way to the medical literature.
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spelling pubmed-58420002018-03-13 Synovium as a widespread pathway to the adjacent joint in undifferentiated high-grade pleomorphic sarcoma of the tibia: A case report Li, Xiaona Zhang, Zekun Latif, Mahrukh Chen, Wei Cui, Jianling Peng, Zhigang Medicine (Baltimore) 6800 RATIONALE: Undifferentiated high-grade pleomorphic sarcoma (UPS), originated from bone, is a rare tumor, accounting for 2% to 5% of all primary maligment bone neoplasms. Skip lesion can be found in undifferentiated high-grade pleomorphic sarcoma of bone (UPS-B). However, the direct invasion across the articular synovium to bone has not been reported previously. PATIENT CONCERNS: We report an unusual case of a 65-year-old man complained of a year history of pain, swelling, and limitation of activity in the left knee joint. At the proximal tibia, there was extensive invasion of articular synovium, which provides a direct anatomic pathway for the tumor invasion to the adjacent bone, including patella and femoral condyle. DIAGNOSES: Magnetic resonance imaging was important in defining the marrow involvement and joint invasion, including the thickening articular synovium. Subsequent pathological examination confirmed the diagnosis of UPS. INTERVENTIONS: The patient underwent an extensive resection of the knee joint, except for the patellar. OUTCOMES: After operation, routine chemotherapy was performed. Unfortunately, half a year later, soft tissue swelling of whole thigh was found. Then this patient came our hospital again. Positron emission tomography imaging showed there was recurrence of UPS with lung metastasis. A week later, this patient died. LESSONS: In contrast to frequent infiltration pathway, the articular synovium as a media for this tumor spread is rare. This study adds a better understanding of this direct invasion way to the medical literature. Wolters Kluwer Health 2018-02-23 /pmc/articles/PMC5842000/ /pubmed/29465573 http://dx.doi.org/10.1097/MD.0000000000009870 Text en Copyright © 2018 the Author(s). Published by Wolters Kluwer Health, Inc. http://creativecommons.org/licenses/by-nd/4.0 This is an open access article distributed under the Creative Commons Attribution-NoDerivatives License 4.0, which allows for redistribution, commercial and non-commercial, as long as it is passed along unchanged and in whole, with credit to the author. http://creativecommons.org/licenses/by-nd/4.0
spellingShingle 6800
Li, Xiaona
Zhang, Zekun
Latif, Mahrukh
Chen, Wei
Cui, Jianling
Peng, Zhigang
Synovium as a widespread pathway to the adjacent joint in undifferentiated high-grade pleomorphic sarcoma of the tibia: A case report
title Synovium as a widespread pathway to the adjacent joint in undifferentiated high-grade pleomorphic sarcoma of the tibia: A case report
title_full Synovium as a widespread pathway to the adjacent joint in undifferentiated high-grade pleomorphic sarcoma of the tibia: A case report
title_fullStr Synovium as a widespread pathway to the adjacent joint in undifferentiated high-grade pleomorphic sarcoma of the tibia: A case report
title_full_unstemmed Synovium as a widespread pathway to the adjacent joint in undifferentiated high-grade pleomorphic sarcoma of the tibia: A case report
title_short Synovium as a widespread pathway to the adjacent joint in undifferentiated high-grade pleomorphic sarcoma of the tibia: A case report
title_sort synovium as a widespread pathway to the adjacent joint in undifferentiated high-grade pleomorphic sarcoma of the tibia: a case report
topic 6800
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5842000/
https://www.ncbi.nlm.nih.gov/pubmed/29465573
http://dx.doi.org/10.1097/MD.0000000000009870
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