Biphasic Synovial Sarcoma of the Extremity: Quadruple Approach of Isolated Limb Perfusion, Surgical Ablation, Adipofascial Perforator Flap and Radiation to Avoid Amputation

Synovial sarcoma is a rare type of soft tissue sarcoma that occurs mostly in young adults, and it is always regarded as a high-grade tumor. Here, we report the case of a 31-year-old German Caucasian male with synovial sarcoma of the wrist who was offered amputation at his local hospital. After referral to our Reference Centre for Soft Tissue Sarcoma, the quadruple approach of isolated limb perfusion, surgical ablation, adipofascial perforator flap and radiation avoided amputation and enabled preservation of good hand function with no evidence of recurrence or metastasis after 1 year.