Desarticulación de cadera por sarcoma sinovial monofásico. Caso clínico.

Hip disarticulation by monophasic synovial sarcoma. Case report. Synovial sarcoma is a clinically and genetically distinct morphological entity, and can be found in any location. There is no standard therapy. Treatment is usually surgical; with radical resection of the lesion, applying, in some cases, adjuvant radiotherapy. Synovial sarcomas have shown chemosensitivity to ifosfamide with an approximate 24% response. They are most often present in the extremities causing metastatic spread to regional lymph nodes and/or lung, liver, bone and brain. It is a clinical case: a female 40 year old patient with a tumor in right leg, on the middle third of the thigh, 15x10 cm in diameter, that involves the anterior, lateral and posterior vastus of the right quadriceps, with emergence of aponeurosis and extension to the subcutaneous tissue. Through immunohistochemical test, immuno-labeling in neoplastic cells with EMA, QAE1/AE3, vimentin, CD99, CD34 and Bcl2, as diagnosis of monophasic synovial sarcoma, was observed. For treatment, hip disarticulation was carried out, no postoperative complications and satisfactory outcome. The patient is referred to medical oncology service for adjuvant treatment. We conclude that surgical procedure in the treatment of tumors in extremities is divided into wide resection of the tumor with preservation of the member by endoprosthesis, and disarticulation amputees, with no clinical evidence to support the benefit of any other treatment option, however, the main purpose of the oncologic procedure is to control the tumor recurrence and improve patient survival.