Table 1 The clinical features and course of reported intra-articular epithelioid sarcoma cases
Study | Age/sex | Symptoms Duration | Imaging | Initial diagnosis Diagnostic approch | Immunohistochemistry | Final diagnosis Treatment | Outcome |
|---|---|---|---|---|---|---|---|
Von Hochstetter et al. (1995) (14) | 27/F | Right knee Pain and swelling 6 months | Plain X-ray revealed an irregular, flocculent calcification in the infrapatellar fat pad | Osteosarcoma probably arising out of synovial chondromatosis Synovectomy | cytokeratin (+), vimentin (+), CD31 (-) | Radical synovectomy Surgical excision | Developed recurrent soft tissue nodular tumor deposits around the right knee with involvement of joint capsule 4 year later |
Hurtado et al. (1998)(12) | 35/M | Left knee Pain 10 months | MRI showed prominent synovial proliferation. Bone scan showed soft tissue uptake at left knee | PVNS (hemorrhagic polypoid synovitis with serosanguineous fluid) Arthroscopy | cytokeratin (+), EMA (+), S100 (-), HMB-45 (-) | Above-knee amputation | One lymph node metastatic involvement and no more details stated |
Kosemehmetoglu et al. (2011)(13) | 19/M | Right knee Pain and swelling 6 years after injury | CT & MRI showed 15 × 13 × 11 cm tumor in knee joint with bone destruction & soft tissue extension | Proximal type ES Not stated | Diffuse cytokeratin (+), variably CD34 (+), complete loss of INI1 | Above-knee amputation for ES | Performed well after 1 year without recurrence or metastasis |
60/F | Right knee mass | Radiographic features not stated and not shown, just described as an intra-articular mass | Proximal type ES Not stated | cytokeratin (+), INI-1(-) | Subtotal excision of synocial mass for ES | Bilateral subpleural metastatic nodules at presentation persisted at follow-up 2 years after diagnosis | |
Chow et al. (2015)(11) | 59/F | Right knee Pain and swelling 6 months after falling | MRI showed synovial thickening and lobulated synovial mass | PVNS Open anterior and posterior synovectomy | CD34、EMA、cytokeratin (+), Ki67 (67%+) S100, CD31, desmin & MSA(-) complete loss of INI1 | Above-knee amputation for synovial ES | Died of disseminated metastasis 20 months after initial presentation |
Martins Rocha T et al. (2018)(9) | 22/M | Left knee Pain and swelling 1 year for no reason | MRI revealed minimal joint effusion, a Baker cyst and a chondral fissure of the patella | Unspecific synovitis arthroscopy | Vimentin (+), cytokeratin (+), EMA (+), S100 (-) and complete loss of INI1 | Radiotherapy and neoadjuvant chemotherapy (doxorubicin and ifosfamide Above-knee amputation | Not stated |
Flikweert et al. (2018)(10) | 60/F | Right knee 6 months | MRI revealed a degenerative medial meniscus, popliteal ‘synovial chondromatosis’, and anterior cruciate ligament thickening | Posttraumatic synovitis arthroscopic partial medial meniscectomy, debridement of chondrocalcinosis and synovium in the femoral notch | CD34 (+); AE1 (+); EMA (+) | Palliative care was initiated focusing on pain relief. Due to the rapid clinical deterioration, she received a chordotomy instead. | The patient deceased three weeks after the definitive diagnosis, 5 and 6 months after her first visit to hospital and her family physician, respectively. |
Zhang et al. (2023) | 13/F | Right knee Pain and swelling 6 months | MRI showed synovial thickening and effusion | Synovitis 1. PVNS? 2. sJIA? Arthroscopy | CKpan, AE1/AE3 (+); CD34, INI-1, CD68, S100, SMA, Desmin, Myogenin, MyoD1, ERG and TLE1 (-) | Due to the metastasis and intolerance of chemotherapy, she mainly adapted palliative care focusing on pain relief. | Died of disseminate metastasis of lymph nodes, lungs and bones 7 months after initial presentation |