Primary Monophasic Synovial Sarcoma Arising in the Mesentery: Case Report of an Extremely Rare Mesenteric Sarcoma Confirmed by Molecular Detection of a SYT-SSX2 Fusion Transcript
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Synovial sarcoma arises in the para-articular tissues, and it can also occur in various unexpected sites. We report a rare case of primary monophasic synovial sarcoma (MSS) arising in the mesentery. A 59-year-old man presented with a palpable abdominal mass. On microscopic examination, the entire tumor comprised a dense proliferation of the spindle cells without epithelial components. The tumor cells were positive for transducin-like enhancer of split 1, bcl-2, epithelial membrane antigen and CD99 but negative for CD34, CD117, alpha-smooth muscle actin, cytokeratin, and calretinin on immunohistochemistry. The reverse transcriptase-polymerase chain reaction revealed a single 151-bp fragment representing the SYT-SSX2 fusion transcript. Because mesenteric MSS is extremely rare and many cases display histologic findings that overlap with those of more frequently involved tumors such as hemangiopericytoma and gastrointestinal stromal tumor, there is a chance of making an incorrect diagnosis that can result in an inappropriate treatment.
Abstract
Synovial sarcoma arises in the para-articular tissues, and it can also occur in various unexpected sites. We report a rare case of primary monophasic synovial sarcoma (MSS) arising in the mesentery. A 59-year-old man presented with a palpable abdominal mass. On microscopic examination, the entire tumor comprised a dense proliferation of the spindle cells without epithelial components. The tumor cells were positive for transducin-like enhancer of split 1, bcl-2, epithelial membrane antigen and CD99 but negative for CD34, CD117, alpha-smooth muscle actin, cytokeratin, and calretinin on immunohistochemistry. The reverse transcriptase-polymerase chain reaction revealed a single 151-bp fragment representing the SYT-SSX2 fusion transcript. Because mesenteric MSS is extremely rare and many cases display histologic findings that overlap with those of more frequently involved tumors such as hemangiopericytoma and gastrointestinal stromal tumor, there is a chance of making an incorrect diagnosis that can result in an inappropriate treatment.
참고문헌 (16)
- Morland B, "Synovial sarcoma of the larynx in a child: case report and histological appearances", Med Pediatr Oncol, 23, pp.64~68 (1994)
- Paláu LM, "Primary synovial sarcoma of the kidney with rhabdoid features", Int J Surg Pathol, 15, pp.421~428 (2007)
- Buiga-Potcoavă R, "Primary intraabdominal synovial sarcoma: a case report", Rom J Gastroenterol, 14, pp.67~69 (2005)
- Cadman NL, "Synovial sarcoma: an analysis of 34 tumors", Cancer, 18, pp.613~627 (1965)
- Fetsch JF, "Synovial sarcoma of the abdominal wall", Cancer, 72, pp.469~477 (1993)
- Fisher C, "Intra-abdominal synovial sarcoma: a clinicopathological study", Histopathology, 45, pp.245~253 (2004)
- Begueret H, "Primary intrathoracic synovial sarcoma: a clinicopathologic study of 40 t(X;18)-positive cases from the French Sarcoma Group and the Mesopath Group", Am J Surg Pathol, 29, pp.339~346 (2005)
- Christopher DM, "World Health Organization classification of tumours: pathology and genetics of tumours of soft tissue and bone", pp.200~204 (2002), IARC Press
- Enzinger FM, "Hemangiopericytoma: an analysis of 106 cases", Hum Pathol, 7, pp.61~82 (1976)
- Weiss SW, "Enzinger and Weiss’s soft tissue tumors", pp.1161~1182 (2007), Mosby
- Fletcher CD, "Diagnosis of gastrointestinal stromal tumors: a consensus approach", Hum Pathol, 33, pp.459~465 (2002)
- Makhlouf HR, "Synovial sarcoma of the stomach: a clinicopathologic, immunohistochemical, and molecular genetic study of 10 cases", Am J Surg Pathol, 32, pp.275~281 (2008)
- Kosemehmetoglu K, "TLE1 expression is not specific for synovial sarcoma: a whole section study of 163 soft tissue and bone neoplasms", Mod Pathol, 22, pp.872~878 (2009)
- Coindre JM, "Should molecular testing be required for diagnosing synovial sarcoma? A prospective study of 204 cases", Cancer, 98, pp.2700~2707 (2003)
- Dal Cin P, "Chromosomes in the diagnosis of soft tissue tumors. I. Synovial sarcoma", Mod Pathol, 5, pp.357~362 (1992)
- de Leeuw B, "Identification of two alternative fusion genes, SYT-SSX1 and SYT-SSX2, in t(X;18)(p11.2;q11.2)-positive synovial sarcomas", Hum Mol Genet, 4, pp.1097~1099 (1995)