Abstract
Introduction: The incidence of malignancy in pregnancy is reported to range approximately between 0.02% and 1%. Synovial sarcoma (SS) is a rare aggressive mesenchymal tumor for which there are no treatment guidelines during pregnancy. Case Report: The authors report a 23-year-old primigravida presenting, at 20+0 weeks of pregnancy, with a growing painful mass in the left thigh. The diagnosis of monophasic SS grade 3 was confirmed by the presence of SYT gene fusion. On MRI scan there was a heterogeneous localized mass of size 75×115×103 mm, but there was no evidence of distant metastases. Limb-sparing surgery with clear-surgical margins was performed at 26+3 weeks of pregnancy. Adjuvant chemotherapy with two cycles of doxorubicin was followed by delivery of normal child by caesarean section at 36+3 weeks of pregnancy. Adjuvant radiotherapy of total dose of 66 Gray to the site of the resection had been administered followed by two cycles of doxorubicin. Conclusion: The patient is free of recurrence six months after the completion of the treatment.
Highlights
Pregnancy-associated malignancy is defined as a neoplastic disease diagnosed during pregnancy or within one year after delivery [1]
A number of soft tissue sarcomas have been reported during pregnancy, including liposarcoma, rhabdomyosarcoma, fibrosarcoma, synovial sarcoma (SS), neurosarcoma, hemangiopericytoma, leiomyosarcoma, myxoma, and unclassified sarcomas [7]
Given the generally increasing trend in the incidence of cancer, it is highly probable that the incidence in pregnancy will rise
Summary
Pregnancy-associated malignancy is defined as a neoplastic disease diagnosed during pregnancy or within one year after delivery [1]. The incidence of cancer during pregnancy reported in the literature ranges between 0.02% and 1% [2-5]. The last 20 years have seen a growing trend in the incidence of pregnancy-associated cancer in the Western world as reproduction plans are made at a later age [8]. Bone and soft tissue sarcomas are a very heterogeneous group of malignant tumors. The incidence of soft tissue sarcomas is about 1% [11]. A number of soft tissue sarcomas have been reported during pregnancy, including liposarcoma, rhabdomyosarcoma, fibrosarcoma, synovial sarcoma (SS), neurosarcoma, hemangiopericytoma, leiomyosarcoma, myxoma, and unclassified sarcomas [7]. SS comprise 8-10% of all soft tissue tumours that are very rarely encountered during pregnancy [10, 12]. Due to the limited data in the literature, it is unclear how these tumours behave during pregnancy [13-15]. In this report the authors present an extremely rare case of monophasic SS of the lower extremity diagnosed at 20+0 weeks of gestation and review the literature
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