No abstract

The incidence of synovial sarcoma is 1.548 per 1,000,000. Synovial sarcoma localized to the palmar surface should, therefore, be considered extremely rare. This report documents a 34-year-old male with a right hand mass that had been present for a few years, continuing to grow in size. The mass was located at the palm and extended from the mid-third metacarpal to involve all digits except the thumb. The mass was determined to be monophasic synovial sarcoma on histopathologic exam. Fluorescence in situ hybridization for SYT gene rearrangement was positive in 72% of cells. Resection of the mass was followed by radiation and chemotherapy. The patient had a long-term follow-up of 3.5 years with no evidence of any local recurrence of the tumor. This report increases awareness of this extremely rare malignancy—an awareness that is crucial for early diagnosis and improved survival rates. It is more common at younger ages but it can occur at any age, so it should be suspected and included in the differential diagnosis, especially when evaluating slow growing, nonresolving hand lesions.

The patella is an uncommon site for a tumor. This report details the incidental finding of an excrescence on the right patella identified in a cadaver during a gross anatomy course. Histological assessment revealed no periosteal surface, a very thin cartilage cap, minimal endochondral ossification, bone intermediate to more cartilage, and degenerative changes. The assessment remains unclear. What is clear, however, is that this incidental finding has served as an excellent interdisciplinary exercise for anatomists and pathologists and has benefited the education of undergraduate and graduate medical students. Accordingly, in addition to the gross pathology and histopathology, a workflow is presented. Support or Funding Information T. Walley Williams Summer Anatomy Research Fellowship; WV Research Challenge Fund [HEPC.dsr.17.06]