ABSTRACT
Upper extremity Axilla A 27-year-old female developed a mass 8 months earlier. She sought medical attention 5 months prior to referral, at which time an 8×7 cm mass was discovered, and 2 months later she was seen with a 10×10 cm mass involving the subscapularis infraspinatus, the proximal biceps and coracobrachialis muscles. A biopsy was consistent with a high-grade synovial cell sarcoma, which was 8×12 cm by the time of presentation (Figure 11.31). She did not respond to three courses of mesna, doxorubicin, ifosfamide, dacarbazine (MAID) chemotherapy and was referred for operation. An extensive multiloculated lesion was resected, including the portion of skin beneath the original biopsy with a skeletonization of the axillary neurovascular bundle. The lesion was completely excised. A nodular excrescence was clearly identified. Afterloading catheters were placed for brachytherapy and primary closure was obtained (Figure 11.32).
