A female patient, age 11 years, presented with a firm, palpable mass in the left lower quadrant of the abdomen. Upon ultrasound imaging, the 3.5 cm × 5 cm lesion was assessed as a benign cyst and a laparoscopic resection of the mass was performed. The initial pathological evaluation reported a diagnosis of fibromyxoid sarcoma. However, after an additional immunohistochemical examination, the diagnosis was changed to grade III synovial sarcoma (CD45–, Bcl+, Desmin–, WT1–, SMA–, Ki65-15%) (Figure 1). Detection of t(X;18) (p11.2; q11.2) translocation was not yet available in Armenia at that time. The pathology report did not include the state of margins. CT and bone scans revealed no metastatic disease at the time.
What would be the best choice for further management of this patient?
C. Resurgery, with further treatment including radiotherapy…