Case Of Primary Synovial Sarcoma Research Articles

Synovial sarcoma of the oral cavity: Report of 4 cases and review of the literature

Abstract Synovial sarcoma is a rare and high-grade soft tissue tumour that rarely affects the head and neck region. Approximately 90% of synovial sarcomas are seen in the extremities. About 5 to 10% occur in the head and neck region with high incidences in the parapharyngeal space and hypopharynx. In the oral cavity, synovial sarcoma has been reported in the buccal mucosa, tongue, floor of the mouth, the retromolar region, hard and soft palates, the gingivobuccal sulcus and the mandible. In this paper, we report 4 very rare cases of monophasic synovial sarcoma of the oral cavity and highlight the need for proper diagnosis and treatment plan in the cases of synovial sarcoma. So far, around 250 cases of synovial sarcoma of head and neck have been reported in the literature. In India, on extensive literature search we could retrieve 18 cases of synovial sarcoma involving the head and neck region, of these 11 cases of primary synovial sarcoma involving the oral cavity have been reported previously. To our knowledge, this is the first series of primary synovial sarcoma of the oral cavity in the Indian literature.

An uncommon case of primary synovial sarcoma of the lung with a rare intraoperative finding

We report a case of a 32-year-old male who was evaluated for right chest pain and cough with streaky hemoptysis. Chest X-ray and contrast-enhanced computerized tomography scan of the chest showed a large (20x16×16 cm), heterogeneously enhancing mass arising from the right lower lobe. Ultrasound-guided Tru-cut biopsy revealed spindle cell sarcoma. In immunohistochemistry, tumor cells expressed epithelial membrane antigen, CD99, and bcl-2. The final diagnosis of primary pulmonary synovial sarcoma was confirmed after positron emission tomography-computed tomography revealed that the lesion was confined to the right lung. The patient was managed by multimodal treatment. The patient underwent right anterolateral thoracotomy and lower lobectomy with staged systematic mediastinal lymphadenectomy. Intra-operatively, he was given 2 units of packed red blood cells (RBCs). The patient developed dark-colored urine near the end of the transfusion of the second unit of packed RBCs, but without any hemodynamic instability. All the tests for possible blood transfusion reactions were negative; thus, we concluded that this event was probably secondary to tumor lysis due to the handling of the large primary lesions during surgery.

Clinicopathologic features of a patient with primary monophasic synovial sarcoma of the jejunum.

A case of primary synovial sarcoma of the jejunum was collected and analyzed retrospectively. A 19-year-old man who presented to hospital with abdominal pain. The CT scan showed a large mixed abdominal mass with bleeding. Laparotomy revealed that the tumor originated from the jejunum, accompanied by rupture and hemorrhage. Microscopically, the tumor was composed of spindle cells. The tumor cells demonstrated diffuse expression of vimentin, transducin-like enhancer (TLE)-1, B-cell lymphoma protein (Bcl)-2, CD99 and focal expression of epithelial membrane antigen (EMA). The presence of specific SS18 gene rearrangement was confirmed in tumor cells. The patient received 6 cycles of chemotherapy after jejunal tumor resection. And 12 months later, the patient presented pancreatic metastasis and had radiotherapy. The patient died 15 months after the diagnosis.

A case of primary synovial sarcoma of the posterior mediastinum with aortic wall infiltration with complete imaging pathway and histological diagnosis.

A case of primary synovial sarcoma of the posterior mediastinum with aortic wall infiltration with complete imaging pathway and histological diagnosis.

A Case of Primary Synovial Sarcoma of the Posterior Mediastinum with Aortic Wall Infiltration with Complete Imaging Pathway and Histological Diagnosis

Danilo Caudo, Alessandro Santalco, Carmelo Anfuso, Ylenia Zullo, Alessandra Pelle, Caterina Benedetto, Annalisa Militi, Viviane Di Dio, Fabio Italiano, Ugo Barbaro Primary synovial mediastinal sarcomas are aggressive tumors with a very rare incidence. The few cases reported in the literature presented poor and incomplete imaging.

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

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.

A rare case of primary synovial sarcoma localized in the thoracic inlet

A rare case of primary synovial sarcoma localized in the thoracic inlet

Synovial sarcoma of the ethmoid sinus

IntroductionSynovial sarcoma is a malignant mesenchymal tumour typically occurring in the extremities. Its occurrence in the head and neck region, particularly in the paranasal sinuses is extremely rare. Case reportHere, we report a case of primary synovial sarcoma of the ethmoid sinus in a 36-year-old female and review the literature of synovial sarcomas arising from the ethmoid sinus. Histopathology was essential in confirming the diagnosis. The patient underwent endoscopic excision of the tumour followed by postoperative radiotherapy. DiscussionAs per our knowledge, only 2 cases of ethmoid sinus synovial sarcoma have been reported in the English literature till date. Although synovial sarcomas rarely involve the paranasal sinuses, they should be included in the differential diagnosis of paranasal sinus tumours. The accepted treatment modality is wide local excision followed by post operative radiotherapy.

The First Ever Reported Case of Primary Synovial Sarcoma of Scalp.

Synovial sarcomas are a rare entity with predilection for extremities and joints. The literature suggests that these tumours are rare in the head and neck region. Very few authors have reported their origin in head. Among the ones occurring in the head region, most of them are found to originate from the parotid area. According to our extensive review of available literature, there has been no reported case of the primary case of synovial sarcoma originating from the scalp convexity. We hereby report one such case in a young female which, by far to the best of our knowledge, is the first ever reported case of a synovial sarcoma occurring on the scalp. The tumour is also the largest ever reported in the literature and posed a great surgical and diagnostic challenge to our team. Through this paper, we recommend that synovial sarcoma should be included as a very rare yet possible differential diagnosis for the scalp tumours.

Synovial sarcoma of the penis: A case report

s / Urological Science 26 (2015) 294e300 298 MP3-3: SYNOVIAL SARCOMA OF THE PENIS: A CASE REPORT Chao-An Chen , Kam-Fai Lee , Kuo-Cai Huang , Kuo-Hsiung Chiu , TzuHsin Yang , Yin-Lun Chang , Jian-Hui Lin , Yung-Chin Huang , Dong-Ru Ho , Chih-Shou Chen , Wei-Yu Lin . Division of Urology, Department of Surgery, Chiayi Chang Gung Memorial Hospital, Chiayi, Taiwan; Department of Anatomic Pathology, Chiayi Chang Gung Memorial Hospital, Chiayi, Taiwan Purpose: Primary synovial sarcoma of the penis is extremely rare. We report a case of synovial sarcoma initially discovered as a painless penile mass with no image evidence of distal metastasis. Synovial sarcoma was reported in the final pathology. Materials and Methods: A 59-year-old male patient is a case of panic disorder under alprazolam treatment for 4 years. He came to our outpatient department for gradual enlargement of penile mass in recentmonths. He is a married man without circumcision. The mass was painless, spherical, and movable over penile base, without skin abnormality or infection signs. Computed tomography revealed a 3.2 cm hypodense mass lesion over left side of corpus cavernosum without enlargement of pelvis or retroperitoneal lymph nodes. Partial penectomy with bilateral inguinal lymph node dissection was performed. Synovial sarcoma within tunica abluginea (pT2) was reported in the final pathology. Results: To our knowledge; this is the first case of primary synovial sarcoma of penis in Taiwan. MP3-4: ADENOCARCINOMA OF URINARY BLADDERe A CASE REPORT Ping-Hao Tsai, Heng-Chieh Chiang, Pao-Hwa Chen. Divisions of Urology, Department of Surgery, Changhua Christian Hospital, Changhua, Taiwan This 78 years old manwho was under regular follow-up post transurethral rsection of prostate gland. During last cystoscope, tumor biopsy was done and the pathologic report reveal possibility of urothelial carcinoma with glandular differentiation, which primary adenocarcinoma or secondary adenocarcinoma involvement especially colorectal origin may be consideration on July, 2015. Afterward, we arranged MRI for tumor staging and it reveals T3N0M0, Stages III. Then, after explain to patient, transurethral resection of bladder tumor was performed on Aug, 2015. The final pathologic report reveals adenocarcinoma arising from urinary bladder. We also arranged colon scope which reveals negative finding. PET scan reveals no uptake for gastrointestinal tract. As exclude colorectal origin of adenocarcinoma, patient is under radiotherapy and chemotherapy for adneomcarcinoma currently. MP3-5: ASSOCIATION BETWEEN HUMAN GLUTATHIONE S-TRANSFERASE OMEGA RS4925 POLYMORPHISM AND BLADDER CANCER Zhon-Min Huang , Jow-Yu Sheu , Min-Che Tung , Chia-Chang Wu, Yuan-Hung Wang . Divisions of Urology, Department of Surgery, Tungs’ Taichung Metro Harbor Hospital, Taichung, Taiwan; Divisions of Urology, Shuang Ho Hospital, Taipei Medical University New Taipei City,

Biphasic synovial sarcoma of the cervical esophagus confirmed by the presence of SYT-SSX1 fusion transcripts

Synovial sarcoma of the digestive tract, including that of the esophagus, is extremely rare. To our knowledge, only 9 cases of primary synovial sarcoma of the esophagus have been reported worldwide. Here, we describe the case of a 70-year-old man who presented with dysphagia and hoarseness, which he had been experiencing for 4 months. A pigmented polypoid mass was detected at the cervical esophagus and spindle cell sarcoma was suspected on the basis of biopsy findings. Two operations were performed to completely excise both the tumor and regional lymph nodes. The tumor was diagnosed as a biphasic synovial sarcoma on the basis of the detection of SYT-SSX1 fusion transcripts by reverse transcription-polymerase chain reaction and fluorescence in situ hybridization. Twenty-two months following surgery, the patient developed local recurrence and received radiotherapy with 60 Gy in 30 fractions. Post-treatment follow-up uncovered the presence of left cervical lymph node metastases that were then removed. Approximately 1 month after resection, multiple metastases developed in the lungs. At his request, the patient did not receive any chemotherapy and died at 42 months after the first operation.

Primary synovial sarcoma of lung.

A synovial sarcoma (SS) is a rare form of cancer which usually occurs near the joints of the arm, neck, or leg, but has been documented in most human tissues and organs, including the brain, prostate, and heart. Primary pulmonary SS is an extremely rare tumor. We report a case of primary SS of lung who presented with severe chest pain and a large right lung mass with right-sided pleural effusion in computed tomography (CT) scan of thorax. The diagnosis was made on the basis of CT-guided core biopsy and immunohistochemistry. On immunohistochemistry, tumor cell expressed epithelial membrane antigen, bcl 2, Vimentin and smooth muscle actin and were immunonegative for S100 and cytokeratin. So, the final diagnosis was primary SS.

Endoscopic sonography and sonographically guided fine‐needle aspiration biopsy in the diagnosis of unusual pancreatic metastases from synovial sarcoma

Pancreatic metastases are commonly solitary solid lesions frequently derived from primary renal cell carcinoma, lung cancer, or melanoma. Very few case reports have described cystic-appearing metastases in the pancreas and even fewer have reported a combination of cystic and solid metastatic lesions. Synovial sarcoma is a rare and aggressive soft tissue neoplasm, frequently metastasizing to the lungs and bones. We present a case of primary synovial sarcoma with multiple solid and cystic-appearing pancreatic metastases diagnosed by endoscopic ultrasound and sonographically guided fine-needle aspiration.

Primary Synovial Sarcoma of the Parietal Pleura: A Case Report

Synovial sarcoma is a malignant soft tissue tumor that most commonly occurs in the extremities of young and middle-aged adults, in the vicinity of large joints. Although synovial sarcoma is frequently associated with joints, it may arise in unexpected sites, such as the mediastinum, heart, lung, pleura, or chest wall. Primary synovial sarcoma of the pleura is rare. To date, nearly 36 cases of primary synovial sarcoma of the pleura have been reported since Gaertner et al. published the first case in 1996. The oncologic characteristics, treatment, and prognosis for pleural synovial sarcomas are not well defined because of a paucity of data. However, a multimodal approach, including surgical resection, chemotherapy, and radiotherapy, has generally been suggested. We report the outcome of one patient with primary pleural synovial sarcoma treated with radical resection and adjuvant treatment.

50 Years Ago in CORR®: Synovial Sarcoma Kirk J. Anderson, MD and Orliss Wildermuth, MD CORR 1961;29:55-70

50 Years Ago in CORR®: Synovial Sarcoma Kirk J. Anderson, MD and Orliss Wildermuth, MD CORR 1961;29:55-70

Intraosseous synovial sarcoma of the proximal femur: Case report.

Synovial sarcoma is primarily a soft tissue malignancy that most often affects adolescents and young adults. It very rarely presents as a primary bone tumour and has only been reported in nine other cases to date. We report a case of primary synovial sarcoma arising from the proximal femur in a 57-year-old man. Synovial sarcoma, primary bone tumour.

13年の間隔を経て再発をきたした胸壁原発滑膜肉腫の1例

症例は41歳，女性．15年前に右胸壁腫瘍の診断で，胸壁腫瘍摘出術を施行され，さらに13年前には右胸壁腫瘍の再発と両側転移性肺腫瘍に対しそれぞれ切除術を施行されていた．これらの病理組織診断は当初すべてmesotheliomaであった．その後，半年に1回程度外来通院し経過をみていたが明らかな再発，転移を認めなかった．初回手術から15年目に胸痛が出現し当院を受診．右胸壁腫瘍の再発と診断し，腫瘍摘出術を施行した．摘出標本の病理組織および遺伝子検索でSYT/SSX1融合遺伝子を検出し，滑膜肉腫と診断した．過去の検体についても同じく遺伝子検査を施行したところ，全てにSYT/SSX1融合遺伝子を検出した．キメラ遺伝子が診断に有用であった1例を経験した．

Synovial Sarcoma in the Rectovesical Space: A Case Report

Synovial sarcoma is the fourth most common type of soft tissue sarcoma (1). It most commonly arises in the extremities and other locations, but in rare cases can arise in the extraperitoneal space (2). Most extraperitoneal synovial sarcomas that were reported arose in the abdominal retroperitoneum (3). Here, we report a case of primary synovial sarcoma arising in the rectovesical space. We present the radiological findings of this disease and discuss the relevant literature review.

Diagnosis and treatment of primary synovial cell sarcoma that occurred in the left mandible body: a case report and literature review

The authors describe a case of synovial sarcoma in the left mandible body. The primary tumor was investigated morphologically and immunohistochemically. The patient was treated with madibulectomy and lymph node dissection, which was followed by an immediate reconstruction of the left mandible with a revascularized osteomyocutaneous fibula free flap. The primary tumor was described as gingival sarcoma. The initial preoperative biopsy showed positive staining for cytokeratin, vimentin, smooth muscle actin, and desmin by immunohistochemistry. The definitive diagnosis of monophasic synovial sarcoma was established following postoperative excision biopsy. Antigens of S-100 and CD99 displayed positive staining but epithelial membrane antigen, Bcl-2, and CD34 were negative. Also, no metastasis or other bone swelling was observed by radionuclide survey suggesting the left mandible was the primary lesion of occurrence. Synovial sarcoma is an uncommon soft tissue malignant neoplasm. This is the sixth case of primary synovial sarcoma occurring in the jaw.

Primary synovial sarcoma of the kidney (literature review with 1 case report)

Objective To discuss the presentations, pathologic features, diagnosis and treatment of primary synovial sarcoma of the kidney. Methods One case of primary synovial sarcoma of the kidney was reported and the relevant literature was reviewed. A 55-year-old man was admitted with complaint of right abdomen and flank pain for 5 h. Computerized tomography revealed a 12.5 cm × 11.0 cm × 9. 0 cm mass located at the middle and lower pole of the right kidney. The patient was taken radical nephrectomy. Results The diagnosis of primary synovial sarcoma of the kidney in the patient was confirmed by postoperative pathology. Under microscope, tumor was typically mitotically active, monomorphic spindle cells growing in intersecting fascicles or in solid sheets with epithelial differentiation. In some areas a haemangiopericytoma-like pattern was found. Immunohistochemical staining showed that the tumor cells were positive for the markers Vimentin, CD99 and Bcl-2, but CK was negative. The patient died of local recurrence and multi-metastasis at 8 months after surgery. Conclusions Primary synovial sarcoma of the kidney is extremely rare with a high grade of malignancy,and its prognosis is poor. The diagnosis depends on pathological features, Immunohistochemical studies and RT-PCR detection. Radical resection combined with chemicaltherapy is considered to be the most reliable treatment so far. Key words: Kidney neoplasms; Sarcoma, synovial; Pathology