Intra-articular epithelioid sarcoma of the knee difficult to differentiate from pigmented villonodular synovitis: A case report and literature review

JOS Case Reports Pub Date : 2023-09-01 DOI:10.1016/j.joscr.2023.06.002

Hideaki Sabe , Yoshinori Imura , Seira Sato , Hidetatsu Outani , Akira Tsujii , Tomoki Ohori , Hiroki Kiyokawa , Eiichi Morii , Seiji Okada

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Abstract

Background

Epithelioid sarcoma (ES) is a rare soft tissue sarcoma typically originating in the distal extremities of young adults. ES rarely occurs in the joint.

Case presentation

A 22-year-old male patient experienced pain, swelling, and limited motion in his right knee. A joint puncture repeatedly revealed hematoma with no symptom improvement. The magnetic resonance imaging revealed hemorrhagic multifocal lobulated masses in the right knee joint, suggesting a pigmented villonodular synovitis (PVNS). An arthroscopic synovectomy was performed for intraoperative frozen section diagnosis of PVNS. However, a definitive ES diagnosis was made. The patient underwent an above-the-knee amputation and a right inguinal lymph node biopsy. The ES diagnosis remained, and the lymph nodes were histologically negative. He had no recurrence 1 year postoperatively.

Conclusion

We report an extremely rare case of intra-articular ES that was difficult to differentiate from PVNS.

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难以与色素沉着绒毛结节性滑膜炎鉴别的膝关节内上皮样肉瘤：一例报告和文献复习

背景上皮样肉瘤（ES）是一种罕见的软组织肉瘤，主要发生在年轻人的远端。ES很少发生在关节中。病例介绍：一名22岁男性患者出现右膝疼痛、肿胀和活动受限。关节穿刺多次发现血肿，症状没有改善。磁共振成像显示右膝关节出血性多灶性小叶肿块，提示色素沉着绒毛结节性滑膜炎（PVNS）。关节镜下滑膜切开术用于PVNS的术中冷冻切片诊断。然而，最终诊断为ES。患者接受了膝盖以上截肢和右腹股沟淋巴结活检。ES诊断仍然存在，淋巴结组织学阴性。术后1年无复发。结论我们报告了一例极为罕见的关节内ES，很难与PVNS鉴别。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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JOS Case Reports

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