A Rare Case of Primary Synovial Sarcoma of Ovary: A Case Report

Abstract

Synovial sarcoma is a malignant neoplasm predominantly of the young age arising from the soft tissues. It does not particularly arise from the synovial membrane and is capable of arising from any tissue. However, it arises most commonly from the para-articular tissue of the extremities. Here, we present a rare case of synovial sarcoma arising from the ovary which mimicked an epithelial ovarian neoplasm on clinical grounds. Our patient is a young 26-year-old unmarried lady who underwent investigations for abdominal pain and lump. She underwent adnexal mass excision, and the histopathology examination noted cells with bizarre nuclei and multinucleation with thick-walled interspersed arborizing vessels. The cells stained positive on IHC for pancytokeratin, CD99 (Figure 4), TLE 1 (Figure 5), FLI-1, CD 34 highlighting vessels and negative for desmin, p16, BCL2. FISH-SYT-SS18 was positive, and FISH-EWSR1 was negative. The pathological features suggested a synovial sarcoma. However, the unusual location of the tumor was worth noting. Although evidence for adjuvant treatment for this is bleak, she was advised adjuvant ifofhamide, but she refused treatment and has relapsed with distant metastasis within 4 months of surgery.