A Rare Case of Synovial Sarcoma Involving the Brachial Plexus, Treated with Wide Local Excision and Reconstructed with Sural Nerve Grafts

This is a case report of monophasic synovial sarcoma involving right brachial plexus. Clinical and radiological examination is not very useful in diagnosis. Histopathology showed spindle cells with occasional mitotic figures. Immunohistochemistry showed positivity for EMA, S-100, Mic-2, Bcl-2, Calponin, TLE-1 and CD-56. Chromosomal translocation t (X;18) (p11.2;q11.2) and chimeric fusion proteins SYT/SSX1 or SYT/SSX2 are formed. Wide local excision of the tumour with involved brachial plexus and later reconstruction of the brachial plexus using sural nerve grafts was done. Patient showed full recovery. Wide excision and radiotherapy is the accepted mode of treatment.