Published online Sep 6, 2019. doi: 10.12998/wjcc.v7.i17.2549
Peer-review started: April 8, 2019
First decision: June 19, 2019
Revised: July 6, 2019
Accepted: July 20, 2019
Article in press: July 20, 2019
Published online: September 6, 2019
Synovial sarcoma (SS), a rare malignant soft tissue tumor whose histological origin is still unknown, often occurs in limbs in young people and is easily misdiagnosed.
We report a 24-year-old man who sought treatment for plantar pain thought to be caused by a foot injury that occurred 4 years prior. Currently, he had been seen at another hospital for a 1-wk history of unexplained pain in the left plantar region and was treated with acupuncture, a kind of therapy of Chinese medicine, which partly relieved the pain. Because of this, the final diagnosis of biphasic SS was made after two subsequent treatments by pathological evaluation after the last operation. SS is rarely seen in the plantar area, and his history of a left plantar injury confused the original diagnosis.
This study shows that pathological and imaging examinations may play a vital role in the early diagnosis and treatment of SS.
Core tip: A young male patient suffered from plantar pain for 1 wk. The symptoms were relieved after a kind of Chinese traditional invasive treatment. After that, the hemogram showed infection and magnetic resonance imaging showed that there was a soft tissue mass with a clear boundary in the plantar region. Rare location, complex medical history, invasive treatment, and auxiliary examination were easy to mislead doctors’ judgments. Finally, the diagnosis was confirmed as synovial sarcoma by pathological examination. This case suggests that when soft tissue mass is encountered, biopsy is always the gold standard and must not be missed.