"Satisfaction of Search" Never Stop Looking -- Before and After Surgery

Case: A 16-year-old female with a history of hip dysplasia and peri-acetabular osteotomy presented with persistent right thigh pain. Given extensive previous workup and non-efficacious intervention, her imaging was re-examined and a small mass was identified in the ipsilateral thigh. Upon biopsy, synovial sarcoma was diagnosed. Following neoadjuvant chemoradiation and surgical resection, the patient reported resolution of pain and improved joint mobility. Conclusion: This is the first reported case of synovial sarcoma presenting in the setting of hip dysplasia. This case highlights the importance of an unbiased evaluation of the patient and critical diagnostic workup in the setting of common unrelated pathology.