Images in clinical medicine | Volume 38, Article 301, 23 Mar 2021 | 10.11604/pamj.2021.38.301.27274

Radiological features of ankle synovial cell sarcoma

Jihane Habi, Nadia Moussali

Corresponding author: Jihane Habi, Department of Radiology, Faculty of Medicine, Mohammed VI University of Health Sciences/Cheikh Khalifa International University Hospital, Casablanca, Morocco

Received: 05 Dec 2020 - Accepted: 04 Mar 2021 - Published: 23 Mar 2021

Domain: Radiology

Keywords: Imaging, synovial sarcoma, ankle

©Jihane Habi et al. Pan African Medical Journal (ISSN: 1937-8688). This is an Open Access article distributed under the terms of the Creative Commons Attribution International 4.0 License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Cite this article: Jihane Habi et al. Radiological features of ankle synovial cell sarcoma. Pan African Medical Journal. 2021;38:301. [doi: 10.11604/pamj.2021.38.301.27274]

Available online at: https://www.panafrican-med-journal.com/content/article/38/301/full

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Images in clinical medicine

Radiological features of ankle synovial cell sarcoma

Radiological features of ankle synovial cell sarcoma

Jihane Habi1,&, Nadia Moussali2

 

1Department of Radiology, Faculty of Medicine, Mohammed VI University of Health Sciences/Cheikh Khalifa International University Hospital, Casablanca, Morocco, 220 Aout Radiology Department of the Ibn Rochd of Casablanca University, Casablanca, Morocco

 

 

&Corresponding author
Jihane Habi, Department of Radiology, Faculty of Medicine, Mohammed VI University of Health Sciences/Cheikh Khalifa International University Hospital, Casablanca, Morocco

 

 

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A 23-years-old man was referred to our institution to investigate a painless right ankle mass. The clinical examination found a painful mass, fixed on the superficial and deep plane with vascular turgor. It measured 15x10cm (A). The X-ray of the ankle was done first and revealed opacity centred on the soft external malleolar tissues (arrow B). Then a magnetic resonance imaging (MRI) was performed. It showed multi lobulated mass with heterogeneous enhancement after injection of gadolinium (C) and a specific triple signal in T2 weighted images (D), made by a hyper signal (liquid), intermediate signal (tumor tissue) and hypo signal (septa). This radiological finding reminds a "bowl of grapes". The extension to the carpal bones was diagnosed as a hyper signal area on T2 (arrow D). The diagnosis of synovial sarcoma was suggested and then confirmed by pathological analysis after performing a surgical biopsy. The patient has developed a metastatic location in the right thigh. Synovial sarcoma is a malignant mesenchymal tumor. It presents 10% of all ankle soft tumors, and affects young adults with a sex ratio of 1. The lesion is often slow growing. On MRI, the synovial sarcoma diagnosis strongly suggestive by the classic "triple sign"; and "bowl of grapes sign" in T2 sequences. Its treatment is based on surgical excision adjunctive with chemotherapy or radiotherapy.

 

 

Figure 1: illustration of ankle synovial sarcoma (A); radiographic X-ray (B); magnetic resonance imaging (C, D)

 

 

 

 

Images in clinical medicine

Radiological features of ankle synovial cell sarcoma

Images in clinical medicine

Radiological features of ankle synovial cell sarcoma

Images in clinical medicine

Radiological features of ankle synovial cell sarcoma

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Key words

Imaging

Synovial sarcoma

Ankle

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