Primary Synovial Sarcoma of the Pharynx: A Series of Five Cases and Literature Review

Synovial sarcoma comprises approximately 10 % of all soft tissue sarcomas. Although synovial sarcoma has been reported in practically every organ, the extremities are the commonest site of occurrence followed by the head and neck. Primary synovial sarcoma of the pharynx is rare and only case reports have been published. We report a series of five cases of primary synovial sarcoma involving the pharynx.     

Intravascular synovial sarcoma of the external iliac vein and reconstruction with the superficial femoral vein

Intravascular synovial sarcoma is a rare neoplasm that arises in large veins of the junctional zone between the proximal leg and lower trunk in adult women. Herein we report the first case of an intravascular synovial sarcoma of the external iliac vein. It was successfully treated with neoadjuvant radiotherapy, radical excisional surgery, and combined arterial and venous reconstruction. Intravascular synovial sarcoma should be considered in the differential diagnosis of any adult woman with deep venous thrombosis and a mass of the femoral or iliac venous system.     

Biphasisches primäres Synovialsarkom der Niere

Primary synovial sarcoma of the kidney is a rare neoplasm, which was first described by Argani et al. in 2000. We report a case of a 47-year-old man presenting with a renal mass of 11.7x9.3x8.1 cm size and a caval thrombus, which was classified as a biphasic differentiated spindle cell tumor. Fluorescence in situ hybridization (FISH) revealed a translocation t(X;18), specific for synovial sarcoma. In younger patients presenting with spindle cell-like renal tumors, a primary synovial sarcoma should be considered as a differential diagnosis.     

Metastatic Breast Tumor Arising from Synovial Sarcoma: Report of a Case

We report a case of metastatic breast tumor arising from a synovial sarcoma of the lower limb. A 27-year-old Japanese woman was diagnosed to have synovial sarcoma 14 months prior to finding a mass in her left breast. An excisional biopsy was performed and a metastatic synovial sarcoma to the breast was confirmed. Eight months after the resection of the breast lesion, the patient developed local recurrences in both her knee and breast. A tumor resection of the limb lesion and a simple mastectomy for the huge lesion, which was diagnosed to be a metastatic breast tumor without lymph node metastasis, were performed. After the operation, the patient received adjuvant systemic chemotherapy. To the best of our knowledge, this is only the second reported case of a solitary metastatic breast tumor arising from synovial sarcoma.     

Hemangiopericytoma-like synovial sarcoma of the lumbar spine. Case report

The purpose of this report is to demonstrate that synovial sarcoma should be included in the differential diagnosis of tumors originating from the lumbar spine, especially if they show hemangiopericytoma-like pathological characteristics. A synovial sarcoma is a mesenchymal spindle cell tumor that displays variable epithelial differentiation including glandular formation. It is unrelated to a synovium. More than 80% of these lesions arise in the deep soft tissue of the extremities. The tumor frequently arises adjacent to joints or tendon sheaths. The authors describe a young woman with a hemangiopericytoma-like tumor of the lumbar spine. During repeated operation, this lesion was shown to be a synovial sarcoma, which had invaded the dura mater. The tumor metastasized to the mediastinum and the intradural cervical spine and, finally, to the brain and the lungs. To the authors' knowledge, this is the first reported case of a synovial sarcoma originating from the lumbar spine.     

Primary monophasic synovial sarcoma of the pleura: diagnosis and treatment

Synovial sarcomas are uncommon soft tissue malignancies that usually affect the extremities in the vicinity of large joints. The recognition of this tumor in an unexpected site, such as the pleura, is often difficult and the monophasic variant of synovial sarcoma is often mistaken for some other spindle cell tumor. In this report, we describe a very rare case of primary monophasic synovial sarcoma of the pleura treated with radical surgery.     

Synovial Sarcoma of the Mediastinum: Report of a Case

We report a case of synovial sarcoma of the mediastinum, a very rare tumor, in a 50-year-old man hos-pitalized with anterior chest pain. Chest X-ray and computed tomography (CT) on admission showed a 10 × 8-cm mass in the right anterior mediastinal space, compressing the superior vena cava. A diagnosis of sarcoma was established by a CT-guided percutaneous needle biopsy. Systemic examination revealed no metastasis to the contralateral pleural cavity or other distant organs, and we resected the mediastinal sarcoma. Pathological and immunohistochemical analyses confirmed a diagnosis of monophasic synovial sarcoma. The patient is alive with recurrence 9 months after his operation, and is receiving chemotherapy with ifosfamide.     

Spontaneous Pneumothorax Secondary to Radiographically Occult Lung Metastasis from Parapharyngeal Synovial Sarcoma: Report of a Case

This report describes a case of secondary pneumothorax caused by a radiographically occult lung metastasis from parapharyngeal synovial sarcoma, a relatively rare tumor known to be highly metastatic to the lung. Although chest X-ray and thoracic computed tomography scan failed to detect the metastatic nodule in the right lung, the surgically resected specimen proved to be a 3-mm lung metastasis. To our knowledge, only eight cases of lung metastases from synovial sarcoma causing pneumothorax have ever been reported. In most of these cases, the lung metastases were detected by radiographical examinations. However, in this patient, the metastatic lesion was not detected during examination. It is speculated that secondary pneumothorax caused by synovial sarcoma may occur during the early stages of lung metastasis. Therefore, if pneumothorax occurs in a patient with a synovial sarcoma, the possibility of lung metastasis should be carefully considered, even if it is undetectable on radiological examinations. Received: February 7, 2001 / Accepted: September 11, 2001     

Pericardial synovial sarcoma: a case report and review of the literature

Primary pericardial synovial sarcoma is a rare disease. We herein report a case of synovial sarcoma that originated in the epicardium. A 13-year-old male visited our hospital with a fever and chest pain. Copious pericardial effusion and a large intrapericardial tumor were detected. An open-chest tumor resection was performed. A solid nodular tumor was observed in the pericardial cavity. The tumor was a polypoid mass that was pedunculated and grew from the inner surface of the pericardium near the origin of the SVC and ascending aorta. Histologically, the tumor cells were uniformly spindle shaped, with an ovoid or oval nucleus, and formed solid, compact sheets and fascicles. A storiform pattern was also observed. Based on the histopathological and immunohistochemical findings, and the fluorescence in situ hybridization detection of rearrangement of the SYT gene, a monophasic synovial sarcoma was diagnosed. We discuss the diagnosis and treatment of this case and review the pertinent literature.     

Primary synovial sarcoma of the kidney

Primary renal synovial sarcomas (SS) are rare tumors of the kidney. Faria first described primary renal synovial sarcoma in 1999. Twenty-one cases of primary renal synovial sarcoma have been reported to date. Primary renal synovial sarcomas can exist in either a monophasic or a biphasic pattern. The monophasic variant of primary renal synovial sarcoma is more common and tends to have a better prognosis than the biphasic variant. We present the case of a 61 year-old woman with a monophasic variant of primary renal synovial sarcoma.     

Synovial sarcoma—unusual presentation with cerebral hemorrhage

Introduction Soft-tissue sarcomas account for 1% of all malignancies in adults. Typical symptoms comprise a growing and painless mass. Occasionally, the diagnosis is facilitated by secondaries.Materials and methods Here we report the first case presented with intracranial hemorrhage caused by a metastasis of a previously unknown synovial sarcoma. The 74-year-old female patient was under anticoagulation for recurrent thrombosis of the right popliteal vein due to compression by the sarcoma, misdiagnosed as Baker`s cyst. The brain metastasis was resected, and after an incisional biopsy of the suspected tumor, which confirmed the diagnosis of a synovial sarcoma, an above knee amputation was performed because of the invasion of the neurovascular structures in the popliteal fossa.Results The patient died 11 months after the initial event from pulmonary and further brain metastases.Conclusion Brain metastases are seldom the primary factor in the management of advanced synovial sarcoma. Initially, the primary tumor was thought to be a benign cyst; we therefore recommend a biopsy/excision of lesions greater than 5 cm in size and with growth tendency to allow appropriate treatment.     

Primary intracranial dural-based synovial sarcoma with an unusual SYT fluorescence in situ hybridization pattern

The authors present the case of an elderly man with a primary dural-based intracranial synovial sarcoma. Histological and immunohistochemical profiles of the lesion were diagnostic for a synovial sarcoma, and molecular studies using fluorescence in situ hybridization were compatible with a synovial sarcoma. A wide array of spindle cell neoplasms has been described as originating in the dura. To the authors' knowledge, however, this is only the second primary dura-based intracranial synovial sarcoma ever reported, emphasizing the importance of a broad differential diagnosis when encountering spindle cell lesions of the meninges.     

Synovial Sarcoma Involving the Calcaneus and Plantar Compartment of the Foot: A Case Report

Synovial sarcoma arising in the foot is a rare finding. We report a 64-year-old female with synovial sarcoma involving the calcaneus and central plantar compartment. The patient presented with a 2-year history of painful heel with soft tissue mass presentation 21 months after initial pain. We performed an incisional biopsy with frozen section; histopathology was consistent with synovial sarcoma.