ENIGMA IN DIAGNOSIS OF A MALIGNANT TUMOR IN THE TIBIA

A 14 year old female patient presented to the orthopaedic department with complains of pain and swelling in the proximal 13rd of right leg since 2 months. History and clinical examination were indicative of a malignant tumour. The patient was investigated with radiography, histopathological examination, immunohistochemistry studies and bone scan to come to definite diagnosis. All the investigations and clinical tests were equivocal and could not provide a definite diagnosis. The definite diagnosis of synovial sarcoma was established only after radical excision of the tumour in the form of amputation. We present this case for the difficulty in establishing the diagnosis of synovial sarcoma and a review of the differential diagnosis considered.