INTRAOSSEOUS SYNOVIAL SARCOMA OF THE MANDIBLE: A CASE REPORT

Évelin Janner,Eduardo Zambaldi Da Cruz,Anderson Abdo Rodrigues,Lucas Novaes Teixeira,Ana Claudia Garcia Rosa,Fabrício Passador-Santos,Vera Cavalcanti De Araújo

doi:10.1016/j.oooo.2019.06.443

Abstract

A 22-year-old man reported a painful swelling on the left side of the mandible for the last 7 months. The patient was otherwise healthy. Radiologic features revealed an extensive multilocular radiolucency involving the left side of the body and ramus of the mandible. Microscopic examination showed a fragment of neoplasm composed by areas with different levels of cellularity. The neoplastic cells exhibited a fusiform morphology with vesicular nuclei and evident nucleolus. Immunohistochemistry analysis revealed that neoplastic cells were positive for cytokeratins (AE1/AE3, focal areas), cytokeratin 7 (focal areas), vimentin (diffusely), CD-99 (focal areas), transducin-like enhancer protein 1 (TLE-1, diffusely) and negative for CD-34, S-100, smooth muscle actin, and HHF-35. These findings in combination supported the diagnosis of synovial sarcoma. The patient was referred for treatment, and hemimandibulectomy on the left side with wide surgical margins is the surgical approach planned. A 22-year-old man reported a painful swelling on the left side of the mandible for the last 7 months. The patient was otherwise healthy. Radiologic features revealed an extensive multilocular radiolucency involving the left side of the body and ramus of the mandible. Microscopic examination showed a fragment of neoplasm composed by areas with different levels of cellularity. The neoplastic cells exhibited a fusiform morphology with vesicular nuclei and evident nucleolus. Immunohistochemistry analysis revealed that neoplastic cells were positive for cytokeratins (AE1/AE3, focal areas), cytokeratin 7 (focal areas), vimentin (diffusely), CD-99 (focal areas), transducin-like enhancer protein 1 (TLE-1, diffusely) and negative for CD-34, S-100, smooth muscle actin, and HHF-35. These findings in combination supported the diagnosis of synovial sarcoma. The patient was referred for treatment, and hemimandibulectomy on the left side with wide surgical margins is the surgical approach planned.

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