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.

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.

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.

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.

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.

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.

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.

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.

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.