Axillary recurrence of the huge number of synovial sarcoma in 1 case.docVIP

 PAGE \* MERGEFORMAT 6 Axillary recurrence of the huge number of synovial sarcoma in 1 case [Keywords:] Sarcoma Patients Wang, male, 39 years old, one and a half ago found Zuoye painless mass in the Ministry of growing up in a local hospital with “fibroma” surgical resection .3 months after recurrence, local excision again, the pathological diagnosis was synovial sarcoma. because of repeated recurrence after surgery and received three concurrent radiotherapy. is now 1 month after surgery, the tumor recurrence to the hospital again. examination: Zuoye area can reach a 10 cm 7 cm mass Ren mass (see Figure 1 ), ill-defined, relatively fixed, the center of about 5 cm 3 cm ulcerated (see Figure 2). redness around the skin edema, skin temperature is slightly higher, no varicose veins. activities severely restricted left shoulder, left upper limb distal feel a little loss, exercise blood flow to normal. left elbow fossa and supraclavicular lymph node enlargement is not palpable. pathologic results were outside the hospital twice a synovial sarcoma, chest, abdominal B-and ECT was not found in high epidural metastases surgery outside the anesthesia. to take the right lateral position, 5 cm from the tumor at the incision for horizontal spindle. layer cut, see most of absence of the latissimus dorsi, teres major tumor located in front of about 10 cm 8 cm 7 cm (see Figure 3), invading the chest size of the muscle, serratus anterior, subscapularis muscle and the teres major, ill-defined, central necrosis was like rotten fish. pedicle of the tumor capsule in the shoulder before the bottom, and teres major and latissimus dorsi tendon adhesion. surgery no tumor invasion and axillary vessels and nerves, natural chest wall is still intact. will be removed the tumor and the affected muscle, muscle dissection deep to chest size and axillary lymph nodes. pathologically confirmed as smooth membrane sarcoma ( grade), without lymph node metastasis. excision wound of about 20