Synovial Sarcoma Mimicking Haemophilic Pseudotumour

Abstract

This is a case of a 36-year-old gentleman with haemophilia A who was presented with an acute atraumatic soft tissue swelling in the right thigh. Open biopsy was performed with the resultant diagnosis of a synovial cell sarcoma. Although the clinical findings were nonspecific they could easily have been found in a bleeding haemophilic pseudotumour. The findings reported on MRI scan initially were highly consistent with those present in patients with mild haemophilia. An important part of orthopaedic management in haemophilia is concerned with intraarticular and intramuscular bleeding. Haematomas are common and sarcomas are rare. However the absence of trauma should alert the clinician to the possibility that the abnormality may represent haemorrhage into a tumour and not just haematoma, even in a haemophilic patient.

A Clinicopathological Analysis of Soft Tissue Sarcoma with Telangiectatic Changes

“…Therefore, subsequent recovery of tumor size after aspiration is an important clue to the presence of STST [1, 7, 8]. …”

Primary malignancies mistaken for pseudotumours in haemophilic patients

“…A 36-year-old Sudanese man with mild haemophilia A presented with an atraumatic swelling in his right thigh that had been present for 6 weeks [5]. Clinically, there was a tender 8 · 10 cm cystic swelling.…”

Malignancy in patients with haemophilia: a review of the literature

“…Unless found as part of a larger report, the literature review of solid tumours excluded specific references to any type of lymphoma or Kaposi sarcoma (KS), benign solid tumours or hepatocellular carcinoma (HCC). After these neoplasms were excluded, 159 cases of malignant solid tumours in persons with haemophilia were identified with an age range of 1.9–78 years [8,15,16,18,23,27–77]. A summary of the data can be found in Table 2 .…”