Synovial Sarcoma Arising in the Foot: Case Report

Synovial sarcomas occur primarily in the soft tissue structures adjacent to the joints and tendons of the extremities. A diagnostic dilemma exists when the clinical presentation is similar to that of an infection or soft tissue trauma. We report a case of soft tissue sarcoma of the foot in a previously healthy 19-year-old male who presented after hitting his right foot against a refrigerator. Initial radiographs were negative; however, 6 weeks later plain radiographs revealed destruction of the metatarsals. Histologic analysis on a specimen obtained via fine-needle aspiration confirmed the diagnosis of primary synovial sarcoma. Further workup revealed metastases to the lungs. An amputation at Chopart’s joint was performed. Primary synovial sarcoma in the foot can mimic infection or edema from a traumatic event. Clinicians should always be suspicious of soft tissue masses and keep neoplastic processes in the list of differentials.