Intraneural Synovial Sarcoma of the Digital Nerve in a Hand by Jeong Hwan Kim, Hyuk Jin Lee, Ilkyu...

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Intraneural Synovial Sarcoma of the Digital Nerve in a Hand by Jeong Hwan Kim, Hyuk Jin Lee, Ilkyu Han, Jae Hong Ha, and Goo Hyun Baek JBJS Case Connect Volume 4(2):e40 May 30, 2014 ©2014 by The Journal of Bone and Joint Surgery, Inc.

Transcript of Intraneural Synovial Sarcoma of the Digital Nerve in a Hand by Jeong Hwan Kim, Hyuk Jin Lee, Ilkyu...

Page 1: Intraneural Synovial Sarcoma of the Digital Nerve in a Hand by Jeong Hwan Kim, Hyuk Jin Lee, Ilkyu Han, Jae Hong Ha, and Goo Hyun Baek JBJS Case Connect.

Intraneural Synovial Sarcoma of the Digital Nerve in a Hand

by Jeong Hwan Kim, Hyuk Jin Lee, Ilkyu Han, Jae Hong Ha, and Goo Hyun Baek

JBJS Case ConnectVolume 4(2):e40

May 30, 2014

©2014 by The Journal of Bone and Joint Surgery, Inc.

Page 2: Intraneural Synovial Sarcoma of the Digital Nerve in a Hand by Jeong Hwan Kim, Hyuk Jin Lee, Ilkyu Han, Jae Hong Ha, and Goo Hyun Baek JBJS Case Connect.

Initial MRI at the outside hospital showed a tumor on the volar side of the index finger.

Jeong Hwan Kim et al. JBJS Case Connect 2014;4:e40

©2014 by The Journal of Bone and Joint Surgery, Inc.

Page 3: Intraneural Synovial Sarcoma of the Digital Nerve in a Hand by Jeong Hwan Kim, Hyuk Jin Lee, Ilkyu Han, Jae Hong Ha, and Goo Hyun Baek JBJS Case Connect.

MRI taken at our clinic showed a recurrence of the tumor on the volar side of the index finger.

Jeong Hwan Kim et al. JBJS Case Connect 2014;4:e40

©2014 by The Journal of Bone and Joint Surgery, Inc.

Page 4: Intraneural Synovial Sarcoma of the Digital Nerve in a Hand by Jeong Hwan Kim, Hyuk Jin Lee, Ilkyu Han, Jae Hong Ha, and Goo Hyun Baek JBJS Case Connect.

Fig. 3 Photograph demonstrating the tumor located in the digital nerve of the index finger.

Jeong Hwan Kim et al. JBJS Case Connect 2014;4:e40

©2014 by The Journal of Bone and Joint Surgery, Inc.

Page 5: Intraneural Synovial Sarcoma of the Digital Nerve in a Hand by Jeong Hwan Kim, Hyuk Jin Lee, Ilkyu Han, Jae Hong Ha, and Goo Hyun Baek JBJS Case Connect.

Fig. 4 Photograph after excision of the tumor.

Jeong Hwan Kim et al. JBJS Case Connect 2014;4:e40

©2014 by The Journal of Bone and Joint Surgery, Inc.

Page 6: Intraneural Synovial Sarcoma of the Digital Nerve in a Hand by Jeong Hwan Kim, Hyuk Jin Lee, Ilkyu Han, Jae Hong Ha, and Goo Hyun Baek JBJS Case Connect.

Microscopic examination of the tumor specimen demonstrated a spindle cell neoplasm with moderately increased cellularity and mild-to-moderate nuclear atypia (hematoxylin and eosin

stain; 10× magnification [left], 200× magnification [right]).

Jeong Hwan Kim et al. JBJS Case Connect 2014;4:e40

©2014 by The Journal of Bone and Joint Surgery, Inc.

Page 7: Intraneural Synovial Sarcoma of the Digital Nerve in a Hand by Jeong Hwan Kim, Hyuk Jin Lee, Ilkyu Han, Jae Hong Ha, and Goo Hyun Baek JBJS Case Connect.

Immunohistochemical staining was focally positive for EMA.

Jeong Hwan Kim et al. JBJS Case Connect 2014;4:e40

©2014 by The Journal of Bone and Joint Surgery, Inc.

Page 8: Intraneural Synovial Sarcoma of the Digital Nerve in a Hand by Jeong Hwan Kim, Hyuk Jin Lee, Ilkyu Han, Jae Hong Ha, and Goo Hyun Baek JBJS Case Connect.

In the FISH study, an SYT gene translocation was observed.

Jeong Hwan Kim et al. JBJS Case Connect 2014;4:e40

©2014 by The Journal of Bone and Joint Surgery, Inc.

Page 9: Intraneural Synovial Sarcoma of the Digital Nerve in a Hand by Jeong Hwan Kim, Hyuk Jin Lee, Ilkyu Han, Jae Hong Ha, and Goo Hyun Baek JBJS Case Connect.

Follow-up MRI at eighteen months after surgery showed no evidence of recurrence.

Jeong Hwan Kim et al. JBJS Case Connect 2014;4:e40

©2014 by The Journal of Bone and Joint Surgery, Inc.