1
|
Tumors of the cardiovascular system: heart and blood vessels. Cardiovasc Pathol 2022. [DOI: 10.1016/b978-0-12-822224-9.00015-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
|
2
|
Coli A, Cassano A, Novello M, Ranelletti FO, Lauriola L. Primary cardiac synovial sarcoma: A review correlating outcomes with surgery and adjuvant therapy. J Card Surg 2019; 34:1321-1327. [PMID: 31441555 DOI: 10.1111/jocs.14214] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
BACKGROUND Cardiac synovial sarcoma (CSS) is an extremely rare malignant tumor with a severe prognosis, due to frequent relapses and metastases. To obtain useful information for treatment protocols, we analyzed survival and therapy data from the cases reported in the literature. METHODS A search of MEDLINE was performed throughout December 2018. Using key words relating to primary CSS, we collected from the literature a total of 97 cases, mainly consisting of single case reports. To identify predictors of overall survival, statistical analyses were performed on a selected cohort of 55 patients for whom relevant clinicopathological data were available, including surgery and adjuvant therapy. RESULTS The univariable analysis revealed that patients in their first three decades of life have better overall survival. The univariable analysis also showed that patients not receiving adjuvant chemotherapy are at increased risk of death. In the multivariable analysis, tumor resection and chemotherapy are factors significantly improving overall survival. CONCLUSION The survival of patients with CSS is positively influenced by a young patient's age and greatly improved by the administration of chemotherapy, even in the absence of tumor resection.
Collapse
Affiliation(s)
- Antonella Coli
- Department of Pathology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma-Università Cattolica del Sacro Cuore, Rome, Italy
| | - Alessandra Cassano
- Department of Medical Oncology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma-Università Cattolica del Sacro Cuore, Rome, Italy
| | | | - Franco O Ranelletti
- Department of Histology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma-Università Cattolica del Sacro Cuore, Rome, Italy
| | - Libero Lauriola
- Department of Pathology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma-Università Cattolica del Sacro Cuore, Rome, Italy
| |
Collapse
|
3
|
|
4
|
Chekrine T, Sahraoui S, Cherkaoui S, Eddakkaoui H, Labsaili H, Marouane S, El Attar H, Zamiati S, Mehadji BE, Benider A. Primary pericardial synovial sarcoma: A case report and literature review. J Cardiol Cases 2013; 9:40-43. [PMID: 30546781 DOI: 10.1016/j.jccase.2013.09.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2013] [Revised: 08/14/2013] [Accepted: 09/14/2013] [Indexed: 11/18/2022] Open
Abstract
Primary pericardial synovial sarcoma is extremely rare, with few published cases in the literature. We report the case of an adolescent aged 13 years with primary pericardial synovial sarcoma discovered during tamponade, confirmed by molecular biology, and for whom treatment combined radiosurgery and adjuvant chemotherapy. The particularity of the case we are reporting stems from the young age of our patient (13 years) as well as the duration of remission, which is quite long (21 months) prior to a superior mediastinal relapse compared to cases reported in the literature. <Learning objective: Synovial sarcoma is difficult to diagnose and has a poor prognosis. Here, a 13-year-old diagnosed with primary pericardial synovial sarcoma was treated with combined radiosurgery and adjuvant chemotherapy leading to continuous remission for 21 months. This regimen could be used to successfully manage future patients. Molecular biology is useful in the diagnosis of synovial sarcoma through the identification of t(X;18) translocation in atypical locations as in the present case.>.
Collapse
Affiliation(s)
- Tarik Chekrine
- Department of Radiotherapy-Oncology, UHC Ibn Rochd, Casablanca, Morocco
| | - Souha Sahraoui
- Department of Radiotherapy-Oncology, UHC Ibn Rochd, Casablanca, Morocco
| | - Siham Cherkaoui
- Department of Pediatric Hematology and Oncology, 20 Août Hospital, UHC Ibn Rochd, Casablanca, Morocco
| | - Houda Eddakkaoui
- Department of Radiotherapy-Oncology, UHC Ibn Rochd, Casablanca, Morocco
| | - Hicham Labsaili
- Department of Cardiovascular Surgery, UHC Ibn Rochd, Casablanca, Morocco
| | - Soufia Marouane
- Central Department of Pathological Anatomy, UHC Ibn Rochd, Casablanca, Morocco
| | - Hicham El Attar
- Anatomy and Pathological Cytology Laboratory, Moulay Idriss I, Casablanca, Morocco
| | - Soumaya Zamiati
- Central Department of Pathological Anatomy, UHC Ibn Rochd, Casablanca, Morocco
| | | | | |
Collapse
|
5
|
Pericardial synovial sarcoma: a case report and review of the literature. Surg Today 2013; 44:2167-73. [DOI: 10.1007/s00595-013-0720-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2013] [Accepted: 06/14/2013] [Indexed: 02/07/2023]
|
6
|
Wang JG, Li NN. Primary cardiac synovial sarcoma. Ann Thorac Surg 2013; 95:2202-9. [PMID: 23647858 DOI: 10.1016/j.athoracsur.2013.01.030] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2013] [Revised: 01/10/2013] [Accepted: 01/18/2013] [Indexed: 11/27/2022]
Abstract
Primary cardiac synovial sarcoma is an extremely rare entity. The clinical and pathologic characteristics are still poorly understood, and prognostic factors influencing overall survival are still unknown. In the present study, all characteristics of reported patients, including sex, age, clinical presentations, laboratory tests, electrocardiogram, imaging findings, pathology, location, therapy, and follow-up were carefully reviewed and survival analysis was performed. The present study has summarized some key features and may provide an effective consultation for the diagnosis and treatment of the tumor.
Collapse
Affiliation(s)
- Ji-Gang Wang
- Department of Pathology, The Affiliated Hospital of Medical College, Qingdao University, Qingdao, China.
| | | |
Collapse
|
7
|
Abstract
Primary cardiac synovial sarcoma is an uncommon malignant neoplasm, with only a handful of cases reported in the English literature to date. Synovial sarcomas have also been described at other unusual sites, such as the heart, pleuropulmonary region, kidney, prostate, liver, mediastinum, retroperitoneum, gastrointestinal tract, and peripheral nerve. For synovial sarcomas that arise at these unusual locations, definitive diagnosis is challenging and requires use of ancillary diagnostic procedures, such as immunohistochemistry, electron microscopy, and molecular genetic techniques, for confirmation of diagnosis. The nonrandom occurrence of t(X;18) has been found consistently in synovial sarcomas. It has also been found as a sole cytogenetic abnormality in some cases, suggesting it as a key molecular event in tumor development. This review highlights salient features of primary cardiac synovial sarcoma and the associated diagnostic challenges.
Collapse
Affiliation(s)
- Tanya Varma
- Department of Pathology, Louisiana State University Health Sciences Center, Shreveport, LA 71130, USA.
| | | |
Collapse
|
8
|
Bendel EC, Maleszewski JJ, Araoz PA. Imaging sarcomas of the great vessels and heart. Semin Ultrasound CT MR 2012; 32:377-404. [PMID: 21963161 DOI: 10.1053/j.sult.2011.06.001] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Primary sarcomas of the aorta, pulmonary artery, superior vena cava, inferior vena cava, and the heart are rare neoplasms. Aortic sarcomas are broadly categorized as either primarily luminal or primarily mural, with luminal sarcomas more likely to be misdiagnosed as thrombus. Pulmonary artery sarcomas are often mistaken for pulmonary embolism both clinically and at imaging. Vena caval sarcomas appear as intraluminal or extraluminal masses connecting to or filling the veins. The most common are leiomyosarcomas of the inferior vena cava. Primary sarcomas of the heart are rare and usually appear as heterogeneous aggressive masses.
Collapse
Affiliation(s)
- Emily C Bendel
- Department of Diagnostic Radiology, Mayo Clinic Rochester, Rochester, MN 55905, USA
| | | | | |
Collapse
|
9
|
Yonezawa I, Saito T, Nakahara D, Won J, Wada T, Kaneko K. Synovial sarcoma of the cauda equina. J Neurosurg Spine 2011; 16:187-90. [PMID: 22098598 DOI: 10.3171/2011.10.spine11359] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Primary synovial sarcoma originating from the cauda equina is extremely rare. Only one case, involving an 11-year-old girl, has been reported. The authors describe the case of a 23-year-old woman with a primary synovial sarcoma of the cauda equina. The patient visited a local hospital and described a 2-month history of low-back pain. She was referred to the authors' hospital for further evaluation. On physical examination, she had a straight-leg raising result of 70° bilaterally. Motor examination revealed Grade 4/5 strength in the bilateral extensor hallux longus muscles. There was normal sensation to light touch and vibration in the lower extremities. Sagittal Gd-enhanced T1-weighted MR imaging demonstrated an intradural, extramedullary, and uniformly enhancing mass that extended from L-3 to L-4. The mass was totally resected and adjuvant local radiation therapy was administered. Reverse transcriptase polymerase chain reaction (RT-PCR) of a paraffin-embedded tissue sample revealed SYT-SSX fusion transcripts, and the diagnosis of synovial sarcoma was confirmed. Five and a half years after surgery, the patient is free of local recurrence and metastatic disease. The RT-PCR detection of SYT-SSX fusion transcripts played a key role in establishing the diagnosis of synovial sarcoma of the cauda equina. Complete resection of the mass with adjuvant local radiation therapy proved to be effective.
Collapse
Affiliation(s)
- Ikuho Yonezawa
- Department of Orthopaedic Surgery, Juntendo University School of Medicine, Tokyo, Japan.
| | | | | | | | | | | |
Collapse
|
10
|
Boulmay B, Cooper G, Reith JD, Marsh R. Primary cardiac synovial sarcoma: a case report and brief review of the literature. Sarcoma 2011; 2007:94797. [PMID: 17671632 PMCID: PMC1931497 DOI: 10.1155/2007/94797] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2006] [Accepted: 04/18/2007] [Indexed: 11/17/2022] Open
Abstract
Synovial sarcoma comprises approximately 10% of all soft tissue sarcoma diagnoses; a primary synovial sarcoma of the myocardium is exceedingly rare. There have been very few cases reported in the literature thus far. With the identification of the characteristic and diagnostic chromosomal abnormality t(X;18), this may become an increasingly recognized entity. Our report adds to the limited published cases of primary cardiac synovial sarcoma with the characteristic t(X;18). Further elucidation of the effects of this translocation on the cell cycle may lead to directed therapies in the future.
Collapse
Affiliation(s)
- Brian Boulmay
- Division of Hematology/Oncology, Department of Medicine, Health Science Center, University of Florida, P.O. Box 100277,
Gainesville, FL 32610, USA
- *Brian Boulmay:
| | - Gary Cooper
- Division of Cardiology, Department of Medicine, Health Science Center, University of Florida, P.O. Box 100277,
Gainesville, FL 32610, USA
| | - John D. Reith
- Department of Pathology, Health Science Center, University of Florida, P.O. Box 100277, Gainesville, FL 32610, USA
| | - Robert Marsh
- Division of Hematology/Oncology, Department of Medicine, Health Science Center, University of Florida, P.O. Box 100277,
Gainesville, FL 32610, USA
| |
Collapse
|
11
|
Abstract
Mesothelioma is a "new" malignant disease strongly associated with exposure to amphibole asbestos exposure (amosite and crocidolite) environmentally and in the work place. Nonetheless, in recent years, we have learned that many cases of mesothelioma are idiopathic, while some are caused by therapeutic irradiation or chronic inflammation in body cavities. This paper reviews the key epidemiological features of the malignancy in the context of the biological and mineralogical factors that influence mesothelioma development. These tumors challenge the diagnostic pathologist's acumen, the epidemiologist's skill in devising meaningful and definitive studies, the industrial hygienist's knowledge of environmental hazards in diverse occupational settings, and the clinician's skill in managing an intrepid and uniformly fatal malignancy.
Collapse
Affiliation(s)
- J E Craighead
- Department of Pathology, University of Vermont, Burlington, VT 05405, USA.
| |
Collapse
|
12
|
Yokouchi Y, Hiruta N, Oharaseki T, Ihara F, Oda Y, Ito S, Yamashita H, Ozaki S, Gomi T, Takahashi K. Primary cardiac synovial sarcoma: A case report and literature review. Pathol Int 2010; 61:150-5. [DOI: 10.1111/j.1440-1827.2010.02631.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
13
|
Kim CH, Dancer JY, Coffey D, Zhai QJ, Reardon M, Ayala AG, Ro JY. Clinicopathologic study of 24 patients with primary cardiac sarcomas: a 10-year single institution experience. Hum Pathol 2008; 39:933-8. [DOI: 10.1016/j.humpath.2007.12.018] [Citation(s) in RCA: 54] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2007] [Revised: 12/27/2007] [Accepted: 12/27/2007] [Indexed: 01/07/2023]
|
14
|
Greene S, Hawkins DS, Rutledge JC, Tsuchiya KD, Douglas J, Ellenbogen RG, Avellino AM. PEDIATRIC INTRADURAL EXTRAMEDULLARY SYNOVIAL SARCOMA. Neurosurgery 2006; 59:E1339; discussion E1339. [PMID: 17277671 DOI: 10.1227/01.neu.0000245619.24603.96] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Abstract
OBJECTIVE
The diagnosis of intradural synovial sarcoma has not been previously published. This report provides a summary of the literature on this tumor and on tumors arising in this location, as well as a description of this patient's clinical course.
CLINICAL PRESENTATION
An 11-year-old girl presented with back pain and radiculopathy. A magnetic resonance imaging scan of the spine revealed a spinal intradural, extramedullary mass at L2–L4 and four additional nodules of enhancement.
INTERVENTION
The mass was nearly totally resected. Radiation and chemotherapy were administered. Intracranial metastases became evident during treatment. The patient died of the disease 14 months after diagnosis.
CONCLUSION
The rapid progression of leptomeningeal metastasis despite maximal treatment demonstrates the aggressive nature of the tumor and the need for further study.
Collapse
Affiliation(s)
- Stephanie Greene
- Department of Neurological Surgery, University of Washington School of Medicine, Children's Hospital and Regional Medical Center, Seattle, Washington, USA.
| | | | | | | | | | | | | |
Collapse
|
15
|
Tong GX, Goldblum JR, Qiu W, Skacel M, Downs-Kelly E, Contractor S, Levine P. Primary intravascular synovial sarcoma: A disease of young adult women? report of a case diagnosed by aspiration biopsy and review of the literature. Diagn Cytopathol 2006; 34:834-8. [PMID: 17183757 DOI: 10.1002/dc.20574] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Intravascular synovial sarcoma (IVSS) is an extremely rare tumor with only four well-documented cases in the English literature. All tumors were located in large veins of the lower extremities or trunk in young women except for one case occurring in a 54-yr-old woman. We report here an additional case of IVSS arising from the superior vena cava in a 32-yr-old woman who presented with a cervical mass and superior vena cava syndrome. A fine-needle aspiration biopsy (FNAB) was performed and showed a malignant biphasic tumor with spindle cell and epithelioid components. The tumor cells were negative for CD31, CD34, factor VIII, desmin, smooth muscle actin, and S-100 protein, and had positive staining for vimentin and cytokeratin (AE1/AE3) predominantly in the spindle and epithelial components, respectively. A diagnosis of synovial sarcoma was made and confirmed in a subsequent transvascular biopsy demonstrating chromosomal translocation t(X, 18) by fluorescence in situ hybridization using a dual color, break-apart-style probe for SYT. Although clinically similar to previously reported IVSS, this is the first case arising in large veins of the upper portion of the trunk and diagnosed by FNAB.
Collapse
Affiliation(s)
- Guo-Xia Tong
- Department of Pathology, Columbia University Medical Center, New York, NY, USA
| | | | | | | | | | | | | |
Collapse
|
16
|
Hazelbag HM, Szuhai K, Tanke HJ, Rosenberg C, Hogendoorn PCW. Primary synovial sarcoma of the heart: a cytogenetic and molecular genetic analysis combining RT-PCR and COBRA-FISH of a case with a complex karyotype. Mod Pathol 2004; 17:1434-9. [PMID: 15494710 DOI: 10.1038/modpathol.3800200] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Synovial sarcomas usually occur in the soft tissues of the extremities of adolescents and middle-aged patients, in the vicinity of large joints. We present a patient with a synovial sarcoma of the left atrium and ventricle, which is an extremely rare location. Diagnosis was confirmed by reverse transcriptase polymerase chain reaction (RT-PCR), showing the t(X;18) fusion transcript. With a multicolor COmbined Binary RAtio labeling Fluorescence In Situ Hybridization (COBRA-FISH) technique, a complex karyotype evolved with identification of derivative chromosomes with multiplex rearrangements. This underscores the importance of molecular analysis of spindle cell tumors in unusual locations. Moreover, it shows that the presumed diagnostic translocation t(X;18) can be embedded in a sequence of other chromosomal rearrangements of which the function is as yet unknown.
Collapse
Affiliation(s)
- Hans Martin Hazelbag
- Department of Pathology, Leiden University Medical Center, 2300 RC Leiden, The Netherlands.
| | | | | | | | | |
Collapse
|
17
|
Kumar S, Chaudhry MA, Khan I, Duthie DJR, Lindsay S, Kaul P. Metastatic left atrial synovial sarcoma mimicking a myxoma. J Thorac Cardiovasc Surg 2004; 128:756-8. [PMID: 15514606 DOI: 10.1016/j.jtcvs.2004.03.037] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Sanjay Kumar
- Department of Cardiothoracic Surgery, Yorkshire Heart Center, Leeds General Infirmary, Great George Street, Leeds, West Yorkshite LS1 3EX, UK
| | | | | | | | | | | |
Collapse
|
18
|
Koletsa T, Kotoula V, Hytiroglou P, Spanos P, Papadimitriou CS. Synovial sarcoma of the heart. Virchows Arch 2004; 444:477-9. [PMID: 15014989 DOI: 10.1007/s00428-004-0994-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2003] [Accepted: 02/16/2004] [Indexed: 10/26/2022]
MESH Headings
- Adult
- Biomarkers, Tumor/analysis
- Echocardiography, Transesophageal
- Heart Neoplasms/chemistry
- Heart Neoplasms/genetics
- Heart Neoplasms/pathology
- Heart Neoplasms/therapy
- Humans
- Immunoenzyme Techniques
- Male
- Neoplasm Proteins/analysis
- Oncogene Proteins, Fusion/analysis
- Oncogene Proteins, Fusion/genetics
- RNA, Neoplasm/analysis
- Radiotherapy, Adjuvant
- Reverse Transcriptase Polymerase Chain Reaction
- Sarcoma, Synovial/chemistry
- Sarcoma, Synovial/genetics
- Sarcoma, Synovial/pathology
- Sarcoma, Synovial/therapy
Collapse
|
19
|
Moch H, Wodzynski A, Guillou L, Nickeleit V. [Primary renal synovial sarcoma. A new entity in the morphological spectrum of spindle cell renal tumors]. DER PATHOLOGE 2004; 24:466-72. [PMID: 14605853 DOI: 10.1007/s00292-003-0654-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
We report 2 primary renal synovial sarcoma. These tumors were formerly designated as embryonal cystic sarcoma of the kidney. Most cases are diagnosed between the ages of 20 and 50 years. Some cases show local recurrence after nephrectomy. On gross examination, tumors are large, partially necrotic, and usually contain cysts. Microscopically, tumors are characterized by monomorphic plump spindle cells. The cysts are lined by mitotically inactive epithelial cells without striking cellular atypia. The spindle cells were immunoreactive for EMA, CD56, and sometimes for CD99. They were non-reactive for desmin, actin, S 100, and cytokeratins. The cyst epithelium is cytokeratin positive. The presence of a SYT-SSX gene fusion resulting from the t(X;18) characteristic for synovial sarcoma was demonstrated by reverse transcriptase polymerase chain reaction in both tumors. Primary renal synovial sarcoma is a distinctive tumor entity, which should be considered in renal tumors consisting of spindle cells.
Collapse
Affiliation(s)
- H Moch
- Institut für Pathologie der Universität, Basel, Schweiz.
| | | | | | | |
Collapse
|
20
|
Affiliation(s)
- Wendy A Cooper
- Department of Anatomical Pathology, Royal Prince Alfred Hospital, Camperdown, NSW, Australia
| | | |
Collapse
|
21
|
Udayakumar AM, Sundareshan TS, Mukherjee G, Biswas S, Rajan KR, Prabhakaran PS. Submandibular synovial sarcoma with t(X;18) and synovial sarcoma of the toe with additional cytogenetic abnormalities: presentation of two cases and review of the literature. CANCER GENETICS AND CYTOGENETICS 2002; 134:151-5. [PMID: 12034530 DOI: 10.1016/s0165-4608(01)00606-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
We report cytogenetic findings from fine-needle aspiration samples of two synovial sarcoma patients. The cases are of interest because (1) one case is of a rare site (submandibular region) of the head and neck, and (2) the other is a patient with synovial sarcoma of the toe showing additional cytogenetic abnormalities along with t(X;18). The literature of this tumor is reviewed.
Collapse
Affiliation(s)
- A M Udayakumar
- Cytogenetics Unit, Department of Pathology, Kidwai Memorial Institute of Oncology, 560 029, Bangalore, India.
| | | | | | | | | | | |
Collapse
|
22
|
Sandberg AA, Bridge JA. Updates on the cytogenetics and molecular genetics of bone and soft tissue tumors. Synovial sarcoma. CANCER GENETICS AND CYTOGENETICS 2002; 133:1-23. [PMID: 11890984 DOI: 10.1016/s0165-4608(01)00626-4] [Citation(s) in RCA: 121] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Avery A Sandberg
- Department of DNA Diagnostics, St. Joseph's Hospital and Medical Center, 350 West Thomas Road, Phoenix, AZ 85013, USA.
| | | |
Collapse
|
23
|
Koyama S, Morimitsu Y, Morokuma F, Hashimoto H. Primary synovial sarcoma of the kidney: Report of a case confirmed by molecular detection of the SYT-SSX2 fusion transcripts. Pathol Int 2001; 51:385-91. [PMID: 11422798 DOI: 10.1046/j.1440-1827.2001.01203.x] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
We describe an unusual case of primary synovial sarcoma of the kidney. A 47-year-old woman had a tumor massively replacing the right kidney. There were no primary extrarenal neoplastic lesions. Microscopically, the tumor was composed of a cellular proliferation of relatively uniform spindle-shaped cells having atypical spindle or oval nuclei arranged in fascicles with tumor necrosis, without epithelial areas. Immunohistochemically, a small number of the tumor cells were positive for epithelial markers such as cytokeratin and epithelial membrane antigen. The SYT-SSX2 fusion transcripts were detected by a reverse transcription-polymerase chain reaction (RT-PCR) using RNA extracted from formalin-fixed, paraffin-embedded tissue. ETV6-NTRK3 fusion gene transcripts that result from t(12; 15)(p13;q25), which is characteristic of cellular congenital mesoblastic nephroma, were not demonstrated. To our knowledge, this is the ninth case of primary renal synovial sarcoma. This case report indicates that synovial sarcoma should be taken into account for the differential diagnosis of renal spindle cell tumors and the molecular assay detecting the SYT-SSX fusion transcripts is useful for the final diagnosis of synovial sarcoma arising in an unusual location.
Collapse
Affiliation(s)
- S Koyama
- Department of Pathology and Oncology, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan
| | | | | | | |
Collapse
|
24
|
Miettinen M, Limon J, Niezabitowski A, Lasota J. Calretinin and other mesothelioma markers in synovial sarcoma: analysis of antigenic similarities and differences with malignant mesothelioma. Am J Surg Pathol 2001; 25:610-7. [PMID: 11342772 DOI: 10.1097/00000478-200105000-00007] [Citation(s) in RCA: 127] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Synovial sarcoma (SS) is a mesenchymal neoplasm that typically shows epithelial differentiation. SS commonly metastasizes to lung and pleura, and has also been reported as the primary in these locations. The histologic distinction of SS from mesothelioma may be difficult because of the combination of epithelioid and spindle cells, potentially shared locations, and antigenic expression. In this study the authors examined 103 well-documented SSs including 41 biphasic, 44 monophasic, and 18 poorly differentiated SSs in comparison with 23 epithelioid and seven sarcomatous mesotheliomas. Most biphasic SSs (29 of 41, 71%) had fields or foci of calretinin-positive tumor cells. The spindle cell components were more often positive (55%), whereas 14% of tumors had positive epithelial cells. The monophasic and poorly differentiated SSs commonly had foci of calretinin-positive cells (in 52% and 56% of cases respectively). In comparison, all 23 epithelioid mesotheliomas (EM) were extensively calretinin positive and seven sarcomatoid mesotheliomas were variably calretinin positive. HBME-1 positivity was similarly detected in biphasic SS and EM (100% and 87% respectively). Among the other sarcomas, two of 15 malignant peripheral nerve sheath tumors were focally calretinin positive, whereas 16 epithelioid sarcomas, 20 leiomyosarcomas, 20 gastrointestinal stromal tumors, and 20 angiosarcomas were negative. Biphasic SSs differed from mesotheliomas by their more common BerEp4 positivity (90%) whereas EMs showed focal reactivity in 13% cases. Marked CD15 reactivity was rare in both. Wilms tumor protein-1 (WT1) was not detected in SS, but was present in 12 of 17 EMs. CD141 was rare in SS, limited to spindle cell components, whereas EMs typically showed prominent membrane staining in epithelial cells. Simple epithelial keratins were present in all epithelial cells of biphasic SS and mesothelioma (keratin 7[K7], K19), but were only focal in monophasic and poorly differentiated SS. Biphasic SSs were extensively K14 positive (89% of cases), whereas epithelial and sarcomatoid mesotheliomas typically showed only scattered positive cells. The potentially shared calretinin patterns in SS and mesothelioma require the use of other markers. The discriminating features include extensive BerEp4 positivity, rarity of CD141, and lack of WT1 in SS. Global expression of K7 and K19 in mesotheliomas versus focal expression in monophasic and poorly differentiated SSs, and differential patterns of K14 expression may also be helpful.
Collapse
Affiliation(s)
- M Miettinen
- Armed Forces Institute of Pathology, Department of Soft Tissue Pathology, Washington, DC 20306-6000, USA
| | | | | | | |
Collapse
|
25
|
Tamborini E, Agus V, Mezzelani A, Riva C, Sozzi G, Azzarelli A, Pierotti MA, Pilotti S. Identification of a novel spliced variant of the SYT gene expressed in normal tissues and in synovial sarcoma. Br J Cancer 2001; 84:1087-94. [PMID: 11308259 PMCID: PMC2363857 DOI: 10.1054/bjoc.2000.1710] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
Synovial sarcoma (SS) is cytogenetically characterized by the translocation t(X;18)(p11.2-q11.2) generating a fusion between the SYT gene on chromosome 18 and one member of the SSX family gene (SSX1; SSX2; SSX4) on chromosome X. Here, we report for the first time that 2 forms of SYT mRNA are present in both normal tissues and SSs. By amplifying the full-length SYT cDNA of two SSs, we detected 2 bands, here designated N-SYT and I-SYT. The latter, previously undescribed, contains an in-frame insertion of 93 bp. Its sequencing revealed a 100% homology with the mouse SYT gene. These two SYT forms were present, although in different amounts, in all human normal tissues examined, including kidney, stomach, lung, colon, liver and synovia. Coexistence of N-SYT and I-SYT (both fused with SSX) was detected in a series of 59 SSs (35 monophasic and 24 biphasic) and in a SS cell line. A preliminary analysis of the differential expression levels of N-SYT and I-SYT in SSs revealed that the latter was consistently overexpressed, suggesting a role in SS pathogenesis.
Collapse
Affiliation(s)
- E Tamborini
- Department of Pathology, Istituto Nazionale per lo Studio e la Cura dei Tumori, Via G. Venezian, Milano, 1 20133, Italy
| | | | | | | | | | | | | | | |
Collapse
|
26
|
Zenmyo M, Komiya S, Hamada T, Hiraoka K, Nagata K, Tsuji S, Hashimoto H, Inoue A. Intraneural monophasic synovial sarcoma: a case report. Spine (Phila Pa 1976) 2001; 26:310-3. [PMID: 11224869 DOI: 10.1097/00007632-200102010-00018] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
STUDY DESIGN A case report. OBJECTIVES To illustrate a rare case of synovial sarcoma arising within a peripheral nerve. SUMMARY OF BACKGROUND DATA A synovial sarcoma arising within a peripheral nerve is very unusual. Only five cases of primary synovial sarcoma within a peripheral nerve have been reported. This is the first case with involvement of the nerve root. The authors diagnosed the tumor arising within the S1 nerve root as synovial sarcoma using cytogenetic analysis that detected the chimeric SYT/SSX gene. METHODS In addition to the immunohistochemical study, a reverse transcription-polymerase chain reaction (RT-PCR) assay was conducted for the SYT-SS10 fusion gene using archival formalin-fixed paraffin-embedded tumor specimens. RESULTS Computed tomography scan, magnetic resonance imaging performed before surgery, and the intraoperative findings showed that the tumor was embedded within the S1 nerve root. Although the histologic findings were suggestive of a malignant peripheral nerve sheath tumor, the results of the cytologic study confirmed its diagnosis of synovial sarcoma. CONCLUSION Primary intraneural synovial sarcoma, although rare, must be distinguished from malignant peripheral nerve sheath tumor. The molecular assay of the detection of the SYT/SSX fusion gene is useful to make a definite diagnosis of monophasic synovial sarcoma.
Collapse
Affiliation(s)
- M Zenmyo
- Department of Orthopaedic Surgery, Kurume University School of Medicine, Japan.
| | | | | | | | | | | | | | | |
Collapse
|
27
|
Abstract
Primary synovial sarcoma of the heart is extremely rare. This report adds another case to the literature and emphasizes that this tumor, although rare, should be considered in the differential diagnosis of left atrial tumors.
Collapse
Affiliation(s)
- F P Casselman
- Department of Thoracic and Cardiovascular Surgery, The Cleveland Clinic Foundation, Ohio 44195, USA
| | | | | | | | | |
Collapse
|
28
|
Bean SH, Sadler DJ, Gray RR, So CB, Morris D. Embolization of pulmonary pseudoaneurysms secondary to metastatic synovial sarcoma of the right atrium. J Vasc Interv Radiol 1999; 10:649-52. [PMID: 10357493 DOI: 10.1016/s1051-0443(99)70096-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Affiliation(s)
- S H Bean
- Department of Diagnostic Imaging, Foothills Hospital, Calgary, AB, Canada
| | | | | | | | | |
Collapse
|
29
|
Oizumi S, Igarashi K, Takenaka T, Yamashiro K, Hiraga H, Fujino T, Horimoto M. Primary pericardial synovial sarcoma with detection of the chimeric transcript SYT-SSX. JAPANESE CIRCULATION JOURNAL 1999; 63:330-2. [PMID: 10475786 DOI: 10.1253/jcj.63.330] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
We report a case of a 19-year-old woman with a primary pericardial synovial sarcoma that extended from the right ventricular free wall to the posterior aspect of the left anterior thoracic wall. Synovial sarcoma was diagnosed by the detection of the chimeric transcript SYT-SSX using reverse transcriptase-polymerase chain reaction (RT-PCR). This transcript is generated by reciprocal translocation between chromosomes X and 18, and is specific to synovial sarcoma that usually occurs in the extremities of young adults. When pathological and immunohistochemical diagnosis of synovial sarcoma is difficult, the molecular biological technique using RT-PCR becomes a powerful method of confirmation of this neoplasm.
Collapse
Affiliation(s)
- S Oizumi
- Department of Clinical Research, Sapporo National Hospital, Japan
| | | | | | | | | | | | | |
Collapse
|
30
|
Donsbeck AV, Ranchere D, Coindre JM, Le Gall F, Cordier JF, Loire R. Primary cardiac sarcomas: an immunohistochemical and grading study with long-term follow-up of 24 cases. Histopathology 1999; 34:295-304. [PMID: 10231396 DOI: 10.1046/j.1365-2559.1999.00636.x] [Citation(s) in RCA: 141] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
AIMS Primary cardiac sarcomas are rare and aggressive tumours. The aims of this study were to precisely classify cardiac sarcomas according to their pathology, and to determine their clinicopathological features and prognosis. METHODS AND RESULTS Twenty-four primary cardiac sarcomas were studied. Clinical features and follow-up of all patients were collected. Histological diagnoses were obtained by combining both morphological features as described in soft tissue counterparts and the immunoprofile of the tumours. The 24 cases were classified as undifferentiated sarcoma (nine cases), angiosarcoma (six cases all located in the right atrium), leiomyosarcoma (six cases), malignant fibrous histiocytoma (one pleomorphic and one giant cell type) and synovial sarcoma (one case). Patients included 14 men and 10 women, with a mean age of 46 years. Clinical manifestations were protean, often delaying the diagnosis. Dyspnoea resulting from obstruction of the cardiac chambers was the most common symptom. Echocardiography and magnetic resonance imaging were useful respectively to detect and to evaluate tumour extension. Complete macroscopic resection was possible in only 33% of patients. The most common cause of death was local recurrence of the tumours (50%), even in the cases of complete macroscopic resection. Whatever the treatment, the prognosis was poor with a mean survival of 16.5 months after diagnosis. CONCLUSIONS All types of sarcomas may be observed in the heart with a predominance of undifferentiated sarcomas. Histological grading, unlike histological type, seems to correlate with survival which remains extremely poor.
Collapse
Affiliation(s)
- A V Donsbeck
- Laboratoire d'Anatomie et de Cytologie Pathologiques, Hôpital cardiovasvulaire et penumologique Louis Pradel, Lyon, France
| | | | | | | | | | | |
Collapse
|
31
|
Abstract
Primary synovial sarcoma of the heart is a rare tumor, with only six previous cases having been reported in the literature. Treatment has included surgery with or without chemotherapy. We present the first case of a documented synovial sarcoma arising from the pericardium in a 19-year-old man. Molecular analysis for t(X; 18) SYT-SSX gene fusion was positive. Radiation treatment was given postoperatively to the entire heart with a boost to the area where the margins were positive.
Collapse
Affiliation(s)
- N Al-Rajhi
- Department of Radiation Oncology, Cross Cancer Institute, Edmonton, Alberta, Canada
| | | | | | | | | |
Collapse
|
32
|
Hisaoka M, Hashimoto H, Iwamasa T, Ishikawa K, Aoki T. Primary synovial sarcoma of the lung: report of two cases confirmed by molecular detection of SYT-SSX fusion gene transcripts. Histopathology 1999; 34:205-10. [PMID: 10217560 DOI: 10.1046/j.1365-2559.1999.00630.x] [Citation(s) in RCA: 56] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
AIMS Primary pulmonary sarcoma is rare, and frequently creates diagnostic challenges. We describe two cases of primary pulmonary spindle cell sarcoma in which a molecular approach using archival paraffin-embedded tissue was proved to aid diagnosis. METHODS AND RESULTS Both patients had huge masses replacing the upper and middle lobes of the lung, respectively, without any primary extrapulmonary neoplastic lesions. Microscopically, the lesions showed a solid hypercellular nodular or lobular growth of atypical short spindle cells in variably intersecting fascicles or in a haphazard fashion, together with focal areas displaying a prominent haemangiopericytoma-like pattern. Immunohistochemically, a small number of the tumour cells were positive for epithelial markers such as cytokeratin and epithelial membrane antigen. In both cases, a reverse transcription-polymerase chain reaction using RNA extracted from formalin-fixed, paraffin-embedded tissues detected SYT-SSX fusion gene transcripts, which are characteristic of synovial sarcoma. CONCLUSION On the basis of the morphological and molecular findings, these tumours are considered to be rare examples of monophasic synovial sarcoma of the lung. Our molecular assay detecting the SYT-SSX fusion transcripts is useful for the final diagnosis of synovial sarcoma arising at such an unusual anatomical site.
Collapse
Affiliation(s)
- M Hisaoka
- Department of Pathology, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan
| | | | | | | | | |
Collapse
|
33
|
Hall TC, Jensen DA, Lohse JR, Shokeir MO. Synovial sarcoma with t(X:18) chromosomal translocation, cardiac involvement, and peripheral embolus. MEDICAL AND PEDIATRIC ONCOLOGY 1999; 32:141-5. [PMID: 9950204 DOI: 10.1002/(sici)1096-911x(199902)32:2<141::aid-mpo13>3.0.co;2-n] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- T C Hall
- Department of Medicine, St. Joseph Hospital, Bellingham, Washington 98225, USA.
| | | | | | | |
Collapse
|
34
|
Cole P, Ladanyi M, Gerald WL, Cheung NK, Kramer K, LaQuaglia MP, Kushner BH. Synovial sarcoma mimicking desmoplastic small round-cell tumor: critical role for molecular diagnosis. MEDICAL AND PEDIATRIC ONCOLOGY 1999; 32:97-101. [PMID: 9950196 DOI: 10.1002/(sici)1096-911x(199902)32:2<97::aid-mpo5>3.0.co;2-j] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
BACKGROUND The identification of recently described nonrandom chromosomal defects specific for various small round-cell and spindle-cell sarcomas can eliminate diagnostic uncertainty arising from the clinical and histopathologic overlap of soft tissue neoplasms. METHODS A 26-year-old man presented with bulky abdominal-pelvic disease. Immunohistochemical and molecular studies on tumor were performed. Treatment was instituted using cycles of high-dose cyclophosphamide (4,200 mg/m2) with doxorubicin (75 mg/m2). RESULTS Clinical findings pointed to desmoplastic small round-cell tumor. The tumor was histologically undifferentiated and immunoreactive for vimentin but negative for other markers. Reverse transcriptase-polymerase chain reaction revealed the SYT/SSX2 fusion transcript of the synovial sarcoma t(X;18) chromosomal rearrangement. The high-dose chemotherapy, plus surgery, achieved a complete remission, but recurrent disease emerged 13 months from diagnosis. CONCLUSIONS This clinically unique case of synovial sarcoma highlights how the use of now readily available molecular techniques will allow more accurate appraisals of the incidence and anatomic distribution of soft tissue neoplasms-information that bears upon pathogenesis and treatment. This case confirms the utility of high-dose alkylator-based therapy for synovial sarcoma. It also demonstrates that with nonlocalized solid tumors, the eradication of minimal residual disease remains an elusive goal. One alternative involves immunologic attack against markers derived from tumor-specific chromosomal defects such as those found in our patient.
Collapse
MESH Headings
- Abdominal Neoplasms/chemistry
- Abdominal Neoplasms/diagnosis
- Abdominal Neoplasms/genetics
- Adult
- Diagnosis, Differential
- Humans
- Immunohistochemistry
- Male
- RNA, Neoplasm/analysis
- Reverse Transcriptase Polymerase Chain Reaction
- Sarcoma, Ewing/chemistry
- Sarcoma, Ewing/diagnosis
- Sarcoma, Ewing/genetics
- Sarcoma, Small Cell/chemistry
- Sarcoma, Small Cell/diagnosis
- Sarcoma, Small Cell/genetics
- Sarcoma, Synovial/chemistry
- Sarcoma, Synovial/diagnosis
- Sarcoma, Synovial/genetics
- Translocation, Genetic/genetics
- Vimentin/analysis
Collapse
Affiliation(s)
- P Cole
- Department of Pediatrics, Memorial Sloan-Kettering Cancer Center, New York, New York 10021, USA
| | | | | | | | | | | | | |
Collapse
|
35
|
Iwasaki H, Ishiguro M, Ohjimi Y, Ikegami H, Takeuchi T, Kikuchi M, Kaneko Y, Ariyoshi A. Synovial sarcoma of the prostate with t(X;18)(p11.2;q11.2). Am J Surg Pathol 1999; 23:220-6. [PMID: 9989850 DOI: 10.1097/00000478-199902000-00012] [Citation(s) in RCA: 59] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
A case of monophasic synovial sarcoma of the prostate in a 37-year-old man is reported. Histologically, the tumor was chiefly composed of uniform spindle and oval cells, which often formed interlacing fascicles resembling those of fibrosarcoma. In some areas, the compact fascicles of tumor cells alternated with hypocellular myxoid tissue bearing a superficial resemblance to peripheral nerve sheath tumors, whereas small portions of the tumor showed a pericytomatous pattern consisting of polygonal cells arranged around dilated, thin-walled blood vessels. By immunohistochemistry, vimentin was detected in most cells, and a focal reactivity for epithelial membrane antigen was also observed. The tumor cells, however, were negative for keratin, S-100 protein, neuron-specific enolase, CD34, desmin, muscle-specific actin, and alpha-smooth muscle actin. Cytogenetic analysis and fluorescence in situ hybridization (FISH) using the cultured tumor cells demonstrated a translocation t(X;18)(p11.2;q11.2), an aberration specific for synovial sarcoma. To the authors' knowledge, this is the first report of a primary prostatic synovial sarcoma confirmed by cytogenetic analysis.
Collapse
Affiliation(s)
- H Iwasaki
- Department of Pathology, Fukuoka University School of Medicine, Japan
| | | | | | | | | | | | | | | |
Collapse
|
36
|
Nicholson AG, Goldstraw P, Fisher C. Synovial sarcoma of the pleura and its differentiation from other primary pleural tumours: a clinicopathological and immunohistochemical review of three cases. Histopathology 1998; 33:508-13. [PMID: 9870144 DOI: 10.1046/j.1365-2559.1998.00565.x] [Citation(s) in RCA: 90] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
AIMS Synovial sarcomas are rare tumours occasionally arising in the pleural cavity, a site where their histological characteristics may be mistaken for those of malignant mesothelioma. We examined three cases of primary pleural synovial sarcoma in order to look for clinicopathological features that may help in distinguishing them from both mesotheliomas and other sarcomas that may arise in the pleura. METHODS AND RESULTS All three patients were male, aged 42, 28 and 42, respectively, and had no known exposure to asbestos. One biphasic tumour contained neutral mucin in focal epithelial elements that also stained positively for BerEP4 and AUA1. All three tumours showed focal positivity for either keratin or EMA in the sarcomatous elements, and they also stained positively for bcl-2 protein and MIC2 gene product (CD99). CONCLUSIONS Our results emphasize the importance of being aware of synovial sarcoma as a possible primary pleural malignancy, especially in a young patient with a localized mass. In addition, the presence of bcl-2 protein perhaps represents a useful marker in distinguishing synovial sarcoma, especially monophasic variants, from mesothelioma within a panel of antibodies.
Collapse
Affiliation(s)
- A G Nicholson
- Department of Histopathology, Royal Brompton Hospital, London, UK
| | | | | |
Collapse
|
37
|
Fujioka M, Suehiro S, Shibata T, Kinoshita H, Wakasa K, Haba T. [Primary cardiac synovial sarcoma--a case report]. THE JAPANESE JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY : OFFICIAL PUBLICATION OF THE JAPANESE ASSOCIATION FOR THORACIC SURGERY = NIHON KYOBU GEKA GAKKAI ZASSHI 1998; 46:923-7. [PMID: 9796299 DOI: 10.1007/bf03217847] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
Abstract
We report a case of cardiac synovial sarcoma, a very rare primary tumor of the heart. The patient was a 29-year-old man with chief complaint of dyspnea. On echocardiography, a tumor 42 mm in diameter occupying the most space of the left atrium was found. The tumor was obstructed the opening of the mitral valve. He was diagnosed with heart failure due to disturbance of the pulmonary venous return and hemodynamic mitral valve stenosis, and underwent surgery. The tumor was a 5-cm sphere originating in the left atrial posterior wall, and was covered with a sheath and solid. The atrial posterior wall was covered with a peel that appeared to be tumor tissue, and this tissue expanded toward the openings of the pulmonary veins bilaterally and the posterior cusp of the mitral valve. The tumor was resected together with the posterior wall. On pathologic examination, the tumor was diagnosed as a synovial sarcoma. Since no other primary focus was found, this tumor was judged to be a primary sarcoma of the heart. The patient was discharged with elimination of symptoms. The sarcoma recurred after 4 months, and the patient underwent a second operation. The recurrent tumor began from the site of resection of the previous operation and expanded up to the inferior pulmonary veins bilaterally. A wide area of the left atrial wall including the tumor was resected, and he was discharged again. The sarcoma recurred again, and he died of progression of heart failure and aggravation of general conditions after 8 months from the first operation.
Collapse
Affiliation(s)
- M Fujioka
- Second Department of Surgery, Osaka City University Medical School, Japan
| | | | | | | | | | | |
Collapse
|
38
|
Movsas B, Teruya-Feldstein J, Smith J, Glatstein E, Epstein AH. Primary cardiac sarcoma: a novel treatment approach. Chest 1998; 114:648-52. [PMID: 9726764 DOI: 10.1378/chest.114.2.648] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
Primary cardiac sarcomas carry a dismal prognosis with no known curative therapy using standard treatment approaches. By its very location, the possibility of a radical complete resection--the underlying principle in the management of any soft-tissue sarcoma--is precluded. While literally in a continuous "blood bath," cardiac sarcomas are associated with a very high rate of hematogenous metastases. This report describes the management of a case in a 51-year-old white man with a high-grade unresectable cardiac sarcoma who was treated with hyperfractionated (twice daily) radiotherapy to a total dose of 7,050 cGy along with a radiosensitizer, (5'-iododeoxyuridine. The patient currently is disease-free and functioning well more than 5 years following this novel treatment approach.
Collapse
Affiliation(s)
- B Movsas
- Department of Radiation Oncology, Fox Chase Cancer Center, Philadelphia, PA 19111, USA
| | | | | | | | | |
Collapse
|
39
|
Hirakawa N, Naka T, Yamamoto I, Fukuda T, Tsuneyoshi M. Overexpression of bcl-2 protein in synovial sarcoma: a comparative study of other soft tissue spindle cell sarcomas and an additional analysis by fluorescence in situ hybridization. Hum Pathol 1996; 27:1060-5. [PMID: 8892591 DOI: 10.1016/s0046-8177(96)90284-1] [Citation(s) in RCA: 69] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
The expression of bcl-2 protein was analyzed in 19 synovial sarcomas and 29 additional soft tissue spindle cell sarcomas as controls by the immunohistologic staining of paraffin-embedded specimens; 15 of 19 (79%) synovial sarcoma cases were positive, but all other spindle cell sarcomas were negative including 20 leiomyosarcomas, 4 malignant peripheral nerve sheath tumors, and 4 fibrosarcomas. In 4 cases of bcl-2-positive synovial sarcoma (3 biphasic and 1 focally glandular type), bcl-2 protein staining was much stronger in the spindle cells than in the epithelial cells. A fluorescence in situ hybridization (FISH) analysis with centromeric and whole chromosome painting probes for chromosome 18 and X was performed on 7 synovial sarcomas. The six cases of bcl-2-positive synovial sarcoma consisted of five cases with the t(X; 18) and one case with tetrasomy of chromosome 18 and X. It has been speculated that bcl-2 protein expression is caused by the 14; 18 translocation and other abnormalities of chromosome 18. This study thus showed the feasibility of such a correlation between bcl-2 protein expression and the characteristic cytogenetic abnormality in the synovial sarcoma-X; 18 translocation. In addition, bcl-2 protein also appears to be a characteristic marker of synovial sarcoma and is thus considered to be potentially useful in distinguishing synovial sarcoma from other spindle cell sarcomas.
Collapse
Affiliation(s)
- N Hirakawa
- Second Department of Pathology, Faculty of Medicine, Kyushu University, Fukuoka, Japan
| | | | | | | | | |
Collapse
|
40
|
Roberts CA, Seemayer TA, Neff JR, Alonso A, Nelson M, Bridge JA. Translocation (X;18) in primary synovial sarcoma of the lung. CANCER GENETICS AND CYTOGENETICS 1996; 88:49-52. [PMID: 8630979 DOI: 10.1016/0165-4608(95)00298-7] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Primary sarcomas of the lung are extremely rare. Among the most common to occur in this location are leiomyosarcoma, fibrosarcoma, and hemangiopericytoma. Many difficulties are encountered when establishing these sarcoma diagnoses, or one of another pathologic type, because of overlapping histologic features and morphologic similarities between primary and metastatic lesions. In this study, the diagnosis of a primary monophasic synovial sarcoma of the lung was aided by the observation of the X;18 translocation characteristic of this neoplasm. To the best of our knowledge, this is the first cytogenetic report of a primary pulmonary synovial sarcoma.
Collapse
Affiliation(s)
- C A Roberts
- Department of Pathology and Microbiology, University of Nebraska Medical Center, Omaha 68198-3135, USA
| | | | | | | | | | | |
Collapse
|
41
|
Abstract
BACKGROUND A 46-year-old man presented with recurrent anemia and polyarthralgia. Investigations revealed a mass in the ileal mesentery, which was resected. Results of routine histologic examination suggested a diagnosis of synovial sarcoma, a rare malignancy usually not reported at this site. METHODS Tissue was examined immunohistochemically, ultrastructurally, and by fluorescent in situ hybridization to confirm the diagnosis. RESULTS Immunohistochemical studies revealed widespread labeling for cytokeratins and focal labeling for desmin and vimentin in the epithelial component, with labeling for epithelial membrane antigen in the epithelial and spindle-cell components. Fluorescent in situ hybridization analysis showed the characteristic t(X;18) translocation of synovial sarcoma. CONCLUSIONS This is a unique case of synovial sarcoma in the small intestinal mesentery. Immunohistochemical labeling confirmed the diagnosis, although, to the authors' knowledge, the pattern of desmin labeling has not been described previously. The clinical association with polyarthralgia, which resolved after removal of the neoplasm, also has not been described previously.
Collapse
Affiliation(s)
- T R Helliwell
- Department of Pathology, University of Liverpool, United Kingdom
| | | | | | | | | | | | | |
Collapse
|
42
|
Nagao K, Gomyo Y, Ito H, Yamamoto K, Yoshida H. A case report of synovial sarcoma with translocation (X;18). Application of fluorescence in situ hybridization to paraffin-embedded tissue. Virchows Arch 1995; 426:519-22. [PMID: 7633662 DOI: 10.1007/bf00193176] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
A 57-year-old female patient with synovial sarcoma in her right foot had a chromosome abnormality defined as translocation (X;18). The tumour was located in the subcutis, and histological investigation showed monophasic proliferation of oval to spindle-shaped cells with a fascicular arrangement lacking an epithelial component. Immunostaining disclosed no cytokeratin or epithelial membrane antigen in tumour cells. Karyotypic analysis revealed translocation (X;18) in addition to other nonspecific aberrations. Fluorescence in situ hybridization was carried out on paraffin-embedded tissue, using DNA probes for the centromeres of chromosomes X and 18 with whole chromosome painting probes for X and 18. The free nuclei showed two signals at a rate of 83-85% with the X and 18 centromeric probes, in contrast to three signals at a rate of 68-70% with the X and 18 painting probes.
Collapse
Affiliation(s)
- K Nagao
- Department of Pathology, Faculty of Medicine, Tottori University, Japan
| | | | | | | | | |
Collapse
|
43
|
Raaf HN, Raaf JH. Sarcomas related to the heart and vasculature. SEMINARS IN SURGICAL ONCOLOGY 1994; 10:374-82. [PMID: 7997732 DOI: 10.1002/ssu.2980100511] [Citation(s) in RCA: 56] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Soft tissue sarcoma is the most common malignant neoplasm of the heart, pericardium, and great vessels. Its presentation is infrequent, nonspecific, and subtle. For example, emboli from these tumors to the lungs or peripheral arteries may mimic thrombotic embolic disease. New noninvasive techniques such as echocardiography and magnetic resonance imaging (MRI) aid in diagnosis and preoperative assessment. Angiosarcoma, the most common cardiac sarcoma, is aggressive and usually arises in the right atrium. Kaposi's sarcoma of the heart has been found in patients with AIDS and in immunosuppressed organ transplant recipients. Most primary sarcomas of the aorta and pulmonary artery (the elastic arteries) show minimal differentiation and are classified as "intimal, sarcomas," whereas leiomyosarcomas predominate in the muscular arteries and great veins. Surgical resection of any sarcoma of the vasculature, when feasible, is technically challenging but may result in cure or palliation. Adjuvant chemotherapy and radiation therapy can also relieve symptoms and prolong survival.
Collapse
Affiliation(s)
- H N Raaf
- Cuvahoga County Coroner's Office, Cleveland, Ohio 44106
| | | |
Collapse
|
44
|
|