Synovial sarcomas are relatively common intermediate-to-high-grade malignant soft tissue tumors, often with an initial indolent course. And among the sarcomas primary intra-abdominal synovial sarcoma is a relatively rare entity that may present with an abdominal mass and diagnosis is usually confirmed by immunohistochemistry. The authors report a case of a 46-year-old man who presented with a large palpable abdominal mass. Contrast-enhanced computed tomography (CT) scan showed a large welldefined heterogeneous intra-abdominal mass filling the entire pelvis and extending upwards till the subhepatic region causing displacement of intra-abdominal organs. However, no other focal lesions were seen in the solid organs. The same findings were confirmed on surgery. Histopathology was suggestive of desmoid tumor/hemangiopericytoma. Immunohistochemistry showed positive markers corresponding to synovial sarcoma. The patient was advised to undergo chemotherapy which was refused and follow-up was lost. After 10 months, patient presented for follow-up CT, which showed marked increase in size of the lesion.
Introduction: MRI offers supplemental diagnostic information in cases of a suboptimal or equivocal ultrasound examination or in patients in whom there is discrepancy between sonographic findings and physical examination. The study aims to determine the role of MRI in evaluating USG proven ovarian lesions with regards to characterization of lesions as benign or malignant. Material and methods: Patients with suspected pelvis mass, referred to the Radiology Department, SN Medical college, Kochi, underwent UGG(GE Logic P5) and as further, MRI was done at Medical Trust Hospital, Kochi, during January 2015 to December 2016. Total 60 patients were included in the study. Results: In our study out of 60 cases, by MRI 22 (36.7%) cases were diagnosed as malignant and 38(63.3%) cases benign. We had sensitivity of 100% in detecting malignant lesions and specificity was 95%, positive predictive value 90.9% and negative predictive value 100%. The study findings showed excellent correlation with the results obtained by others studies. Conclusions:For ovarian lesions, in whom there is discrepancy between ultrasound findings and physical examination, MRI should be the choice. Usefulness of MRI in evaluating adnexal and uterine masses is due to its high sensitivity and specificity, accurate in finding the origin of mass, and to stage malignancies.
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