Synovial sarcoma of the foot and ankle

Synovial sarcoma of the foot and ankle frequently is misdiagnosed, which le ads to delays in treatment. The clinical records of 14 patients with synovi al sarcoma of the foot and ankle were reviewed. Common findings at presenta tion were an enlarging mass with a variable incidence of pain, tenderness, and edema, The patients tended to be younger than patients with Other soft tissue sarcomas (30 years) and had a median duration of symptoms of 14 mont hs. Of the 14 patients, 12 underwent an attempted curative surgical procedu re, Ten patients had partial foot amputations or below knee amputations, wh ereas two had an attempted limb salvage by wide resection, Of the 14 patien ts, one experienced regionally recurrent disease and eight had pulmonary me tastasis developed, All patients who had metastasis develop died of their d isease, Tumor size was not observed to be a prognostic variable in this gro up of patients. Patients with biphasic histologic features had a better out come than did those with a monophasic subtype, Patients with a prolonged du ration of symptoms before diagnosis had a better outcome, presumably becaus e these tumors biologically were less aggressive. Wide resection can be con sidered in a select group of patients.