Synovial sarcoma of the popliteal fossa

Soft tissue sarcomas are heterogeneous group of neoplasms making up to 1% of all malignant tumors in the adult population. The tumor generally appears on the extremities near large joints of middle-aged patients, especially in the popliteal fossa. Our patient presented in February 2014 due to a slowly enlarging, darker-colored swelling in the left popliteal fossa. Upon physical examination, a somewhat nodular, immobile, tender subcutaneous mass was observed. There was no locoregional lymphadenopathy. Patohistological findings showed a high-grade primary malignant mesenchymal tumor, biphasic synovial sarcoma type. The patient underwent surgery with wide surgical excision, followed by radiotherapy treatment. Magnetic resonance imagining follow up after one year revealed tumor recurrence. Neurovascular bundle involvement was detected, but without adjacent bone and muscular invasion and above-the-knee partial amputation of the left leg was performed. The intervention resulted in a remission of the neoplastic process and the patient was scheduled for regular check-ups. Broad surgical resection of the tumor with negative margins was the primary treatment in this case. Mutilating operations are necessary when anatomical structures around the tumor do not allow complete reintervention.

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Synovial Sarcoma: Current Concepts and Future Perspectives

Journal of Clinical Oncology ◽

10.1200/jco.2017.75.1941 ◽

2018 ◽

Vol 36 (2) ◽

pp. 180-187 ◽

Cited By ~ 35

Author(s):

Silvia Stacchiotti ◽

Brian Andrew Van Tine

Keyword(s):

Synovial Sarcoma ◽

Tumor Biology ◽

Soft Tissue Sarcomas ◽

Predictive Biomarkers ◽

Surgical Excision ◽

The United States ◽

Future Research ◽

Global Methylation ◽

Neo Adjuvant Chemotherapy ◽

The Impact

Synovial sarcoma (SS) is a rare sarcoma driven by a translocation between SS18 and SSX 1, 2, or 4. With approximately 800 to 1,000 cases a year in the United States, it most commonly affects young adults between the ages of 15 and 30 years. The resultant tumors are either monophasic (pure sarcomas), biphasic (a combination or epithelioid and sarcomatous components), or poorly differentiated. The hybrid transcription factor SS18:SSX alters SWItch/Sucrose Non-Fermentable (SWI/SNF) chromatin remodeling and global methylation patterns that may allow for future therapeutic opportunities. In this review, we focus on the pharmacologic management of SS, both in the curative setting, where the standard approach is wide surgical excision combined with radiotherapy and/or (neo)adjuvant chemotherapy as appropriate, and in the palliative setting. In advanced disease, chemotherapy with anthracyclines and/or ifosfamide, trabectedin, or pazopanib has been demonstrated to be more active compared with other soft tissue sarcomas. In addition, a better understanding of the molecular and immunologic characteristics of SS has allowed for the identification of new potential targets and the development of novel biology-driven therapies that are all at different stages of testing. There include targeted agents, immunotherapy, and metabolic therapies. Because the impact of these strategies for improving SS outcome is still limited, current and future research is strongly needed to better understand the tumor biology, to identify predictive biomarkers, and to improve the outcomes for patients with SS.

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Synovial sarcoma of the hand-wrist: a case report and review of the literature

Journal of Medical Case Reports ◽

10.1186/s13256-020-02613-4 ◽

2021 ◽

Vol 15 (1) ◽

Author(s):

Serenella Serinelli ◽

Lorenzo Gitto ◽

Daniel J. Zaccarini

Keyword(s):

Literature Review ◽

Synovial Sarcoma ◽

Malignant Tumors ◽

Surgical Excision ◽

Caucasian Woman ◽

Review Of The Literature ◽

Case Presentation ◽

Synovial Sarcomas ◽

Uncommon Case

Abstract Background Synovial sarcomas are infrequent malignant tumors occurring mostly in adolescents and young adults. The occurrence of synovial sarcoma in the hand-wrist area is rare (4 to 8.5% of all synovial sarcomas in different studies). Case presentation This report documents an uncommon case of synovial sarcoma occurring in the hand-wrist of a 69-year-old Caucasian woman. She was subsequently treated with surgical excision and radiotherapy without recurrence after follow up. Conclusions This paper aims to characterize the demographic, pathologic, and clinical features with a literature review. The present literature review confirms that hand-wrist synovial sarcomas are more frequent among males and subjects 10 to 40 years old. Most cases in this location are usually not larger than 5 cm in size. The five-year survival rate is higher than that reported in a previous review on hand synovial sarcomas, and this suggests an improved survival in recent decades.

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Synovial Sarcoma of the Spine: A Rare Intradural Extramedullary Tumour

Nepal Journal of Neuroscience ◽

10.3126/njn.v17i3.33125 ◽

2020 ◽

Vol 17 (3) ◽

pp. 45-49

Author(s):

Ajay Sebastian Carvalho ◽

Kishan Kumar Yadav ◽

Vijay Kumar Gupta

Keyword(s):

Synovial Sarcoma ◽

Soft Tissue Sarcomas ◽

Surgical Excision ◽

Spinal Tumor ◽

Spinal Tumors ◽

Histopathological Diagnosis ◽

Dumbbell Tumor ◽

Imaging Characteristics ◽

The Right ◽

Intradural Extramedullary Tumour

Synovial sarcoma (SS) accounts for 5- 10% of all adult soft-tissue sarcomas and only 5% arises in the spine. It presents like any other spinal tumor, namely axial pain with symptoms due to neural compression. Imaging findings can also be similar to any other benign spinal tumor. We present a 43-year-old male who presented with symptoms of radiculopathy and neural compression and imaging revealed a dumbbell tumor at C6 to D1 with transforaminal and paraspinal extension on the right side. After surgical excision the histopathology revealed a rare synovial sarcoma of the spine. Synovial sarcoma of the spine though rare, are difficult to differentiate based on their presentation and imaging characteristics from benign spinal tumors. However, subtle findings on imaging and a pre-operative biopsy may aid in performing a more definitive surgery upfront rather than a re-do surgery after the histopathological diagnosis.

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Synovial Sarcoma: A Clinical Review

Current Oncology ◽

10.3390/curroncol28030177 ◽

2021 ◽

Vol 28 (3) ◽

pp. 1909-1920

Author(s):

Aaron M. Gazendam ◽

Snezana Popovic ◽

Sohaib Munir ◽

Naveen Parasu ◽

David Wilson ◽

...

Keyword(s):

Synovial Sarcoma ◽

Soft Tissue Sarcomas ◽

Chromosomal Translocation ◽

Surgical Excision ◽

Tumor Grade ◽

Disease Recurrence ◽

Definitive Treatment ◽

Adjuvant Radiation ◽

Subsequent Formation ◽

Synovial Sarcomas

Synovial sarcomas (SS) represent a unique subset of soft tissue sarcomas (STS) and account for 5–10% of all STS. Synovial sarcoma differs from other STS by the relatively young age at diagnosis and clinical presentation. Synovial sarcomas have unique genomic characteristics and are driven by a pathognomonic t(X;18) chromosomal translocation and subsequent formation of the SS18:SSX fusion oncogenes. Similar to other STS, diagnosis can be obtained from a combination of history, physical examination, magnetic resonance imaging, biopsy and subsequent pathology, immunohistochemistry and molecular analysis. Increasing size, age and tumor grade have been demonstrated to be negative predictive factors for both local disease recurrence and metastasis. Wide surgical excision remains the standard of care for definitive treatment with adjuvant radiation utilized for larger and deeper lesions. There remains controversy surrounding the role of chemotherapy in the treatment of SS and there appears to be survival benefit in certain populations. As the understanding of the molecular and immunologic characteristics of SS evolve, several potential systematic therapies have been proposed.

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Child’s problems with Synovial Sarcoma – case study

Pielegniarstwo XXI wieku / Nursing in the 21st Century ◽

10.1515/pielxxiw-2016-0010 ◽

2016 ◽

Vol 15 (1) ◽

pp. 60-63

Author(s):

Natalia Barcik ◽

Agnieszka Nowak ◽

Bożena Krawczyk

Keyword(s):

Synovial Sarcoma ◽

Malignant Tumor ◽

Malignant Tumors ◽

Soft Tissue Sarcomas ◽

Difficult Problem ◽

Health Condition ◽

Central Nervous System Tumor ◽

Left Hand ◽

Sense Of Security ◽

Care Problems

AbstractIntroduction. Soft tissue sarcomas are a heterogeneous group of malignant tumors derived from the embryonic mesenchymal and neuroectodermal tissue. In Poland, they constitute about 7% of all childhood malignant tumors and represent the fifth group of the most common tumorous under the age of 16 after leukemia, central nervous system tumor, lymphoma and neuroblastoma. When starting treatment of a child with cancer, the following points should be taken into account: the type, localization and size of cancer with its dynamics and the stage of disease, the general condition and the age of a patient. The contemporary treatment of patients with malignant tumor is combined and multi-profile. This treatment consists of multidrug chemotherapy, surgery, radiotherapy, rehabilitation and palliative care.In order to analyze care problems of a child with malignant tumor, we present the case of a girl with Synovial Sarcoma who was diagnosed after a year and a half since the first symptoms have occurred. It had a significant impact on the girl’s health condition, emotional and social development as well as on the functioning of her whole family.Aim. The aim of the study was to present the problem associated with a care of a child with malignant tumor based on the analysis of a chosen clinical occurrence.Material and methods. Analysis of medical records of the child was diagnosed thenar tumor of the left hand Synovial Sarcoma and the anamnestic interview with the family.Results and conclusions. Problems of the child diagnosed with cancer are significantly associated with somatic symptoms of the disease such as pain, or complications of chemotherapy. Equally important are the issues related to child mental sphere. A difficult problem is anxiety and impaired sense of security, particularly in cases when the diagnosis process is very long.

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Malignant Nerve Sheath Tumors of the Head and Neck

Otolaryngology ◽

10.1177/019459988809900308 ◽

1988 ◽

Vol 99 (3) ◽

pp. 309-314 ◽

Cited By ~ 30

Author(s):

Dieter F. Hoffmann ◽

Edwin C. Everts ◽

James D. Smith ◽

Damianos D. Kyriakopoulos ◽

Stephen Kessler

Keyword(s):

Head And Neck ◽

Soft Tissue Sarcomas ◽

Surgical Excision ◽

Primary Treatment ◽

Lateral Neck ◽

Postoperative Radiation Therapy ◽

Nerve Sheath Tumors ◽

Nerve Sheath ◽

The Face ◽

Primary Modality

Malignant nerve sheath tumors comprise approximately 5% of all soft tissue sarcomas; only 8% to 15% of these tumors arise in the head and neck. Most tumors appear as a rapidly expanding nonpainful mass in the face or lateral neck. Reported association with Von Recklinghausen's disease varies from 26% to 70%. Wide surgical excision is generally the recommended primary treatment. Recently, there has been a trend to include postoperative radiation therapy as a primary modality.

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Modern aspects of tactics in the genital herpes viral infection (literature review)

GYNECOLOGY ◽

10.26442/2079-5696_2018.2.67-73 ◽

2018 ◽

Vol 20 (2) ◽

pp. 67-73

Author(s):

T Yu Pestrikova ◽

E A Yurasova ◽

I V Yurasov ◽

A V Kotelnikova

Keyword(s):

Literature Review ◽

Viral Infection ◽

Genital Herpes ◽

Fetal Death ◽

Malignant Tumors ◽

Adult Population ◽

Viral Disease ◽

Intrauterine Fetal Death ◽

Complicated Course ◽

Simplex Virus

Genital herpes affects all population groups. 98% of the adult population worldwide have antibodies to the herpes simplex virus (HSV-1 or 2). This viral infection is a significant medical and social problem. HSV can lead to a complicated course of pregnancy, causing miscarriages, premature birth, intrauterine fetal death, systemic viral disease in newborns. There is evidence that HSV has a connection with malignant tumors of the prostate and cervix, contributing to their development. This literature review contains modern aspects of epidemiology, etiology, pathogenesis, clinic, diagnosis, treatment of genital herpes, including its recurring forms with valacyclovir (Valvir). Indications for hospitalization of patients with genital herpes were noted and the prognosis of this pathology was determined. The tactics of managing pregnant women with this pathology is presented.

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LOCAL RECURRENCES AFTER THE TREATMENT OF SOFT TISSUE MALIGNANT FIBROUS HISTIOCYTOMA (UNCLASSIFIEDPLEOMORPHIC SARCOMA) OF THE LIMBS

Wiadomości Lekarskie ◽

10.36740/wlek201908120 ◽

2019 ◽

Vol 72 (8) ◽

pp. 1523-1526

Author(s):

Oleksandr O. Lytvynenko ◽

Volodymyr F. Konovalenko ◽

Anton Yu. Ryzhov

Keyword(s):

Soft Tissue ◽

Malignant Fibrous Histiocytoma ◽

Fibrous Histiocytoma ◽

Survival Rates ◽

Soft Tissue Sarcomas ◽

Primary Treatment ◽

Radical Excision ◽

Local Recurrences ◽

Results Of Treatment

Introduction: The treatment of patients with malignant fibrous histiocytoma as well as other soft tissue sarcomas is not sufficiently effective up to date, and has largely changed and reflects the alterations, occurred in oncology as a whole. The number of amputation decreased over the last 10-15 years. Some researchers associate the improvement of treatment outcomes with the development of combined and complex methods. The aim of the study is an improvement of the results of treatment of patients with soft tissue malignant histiocytoma on the basis of determination of factors, influencing local recurrence development. Materials and methods: The basis of our study was a comprehensive analysis of examination and treatment results of 130 patients with MFH of the soft tissue of limbs, of them in 84 patients (64.6%) the recurrences developed. The group included 45 (53.6%) males and 39 (46.4%) females. The major part of patients – 82.1% (60 patients) were older than 40 years. Results and conclusions: The number of recurrences after the treatment in general surgical facilities is 86.9%, whereas in the patients after the treatment in the specialized oncological facilities this figure is twice lower (40%). The characteristic of the medical facility where the patient receives his/her primary treatment largely affects the development of local recurrences, patients’ quality of life and overall survival rates. The surgical method remains the leading modality in the treatment of MFH of ST. Wide and radical excision of tumors in the specialized oncological facilities allows achieving better survival outcomes of the patients.

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Primary stromal sarcoma of breast: A case report and literature review

Breast Disease ◽

10.3233/bd-201012 ◽

2021 ◽

pp. 1-7

Author(s):

Mohammad Al-Wiswasy ◽

Mahmoud Al-Balas ◽

Raith Al-Saffar ◽

Hamzeh Al-Balas

Keyword(s):

Malignant Tumors ◽

Histopathological Examination ◽

Prognostic Significance ◽

Total Duration ◽

Young Patients ◽

Soft Tissue Sarcomas ◽

Breast Mass ◽

Resection Margins ◽

Stromal Sarcoma ◽

First Case

INTRODUCTION: Primary breast sarcoma (PBS) was first described in 1887 as a rare heterogeneous neoplasm arising from the mesenchymal tissue of the mammary gland accounting for less than 5% of all body soft-tissue sarcomas and less than 0.1% of all malignant tumors of the breast. CASE PRESENTATION: A 31-year old lady presented with left breast mass which she felt four years before during which the mass increased in size from 1 to 6 cm in the largest diameter, diagnosed clinically as a benign fibroadenoma without any further cytological or histopathological confirmation. Histopathological examination of the excised breast mass reveals undifferentiated, primary stromal sarcoma of the breast (PSSB), which was followed by mastectomy three weeks later with reconstructive breast surgery with a total duration of follow-up of 3 years thereafter. This is the first case of PSSB reported in Jordan. DISCUSSION/CONCLUSION: PSSB is the generic term given to malignant breast tumors thought to arise from the specialized mesenchymal stroma of the breast but lacking an epithelial component with a phylloides pattern. PSSB is difficult to diagnose preoperatively due to its rarity and inadequate imaging methods to establish an exact diagnosis. The histology of the patient mass may be the leading factor for the management of these tumors. Even in very young patients, a progressively growing breast mass should alert the clinician to investigate for malignancy and verify the results by biopsy. Surgery with adequate resection margins represents the only potentially curative modality with prognostic significance. Adjuvant chemotherapy and radiotherapy are not very beneficial. The prognosis is dismal for patients with lymph node involvement and the size of the tumor has a lesser bearing on the outcome.

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The management of pancreatic metastasis from synovial sarcoma of the soft tissue: A case report

Rare Tumors ◽

10.1177/2036361320983691 ◽

2020 ◽

Vol 12 ◽

pp. 203636132098369

Author(s):

Bouhani Malek ◽

Sakhri Saida ◽

Jaidane Olfa ◽

Kammoun Salma ◽

Slimene Maher ◽

...

Keyword(s):

Synovial Sarcoma ◽

English Literature ◽

Surgical Excision ◽

Left Thigh ◽

Pancreatic Tumors ◽

Pancreatic Metastasis ◽

Pancreatic Metastases ◽

Pancreatic Biopsy ◽

Diagnostic Difficulties ◽

History Of

Pancreatic metastases are rare, accounting for 2%–3% of pancreatic tumors. The pancreas represents an unusual metastatic site of synovial sarcoma (SS) outside the usual localizations (regional nodes, lung, bone, and liver). The diagnosis is evoked by the personnel medical history of SS and imaging then confirmed by histological examination of the guided pancreatic biopsy. Its therapeutic management is mainly surgical with extensive removal of the lesion. So far only four cases have been reported in the English literature. We reported the case of a male aged 30-year-old who was admitted to our Institute for a local recurrence of SS of the left thigh which was initially treated by surgical excision. The patient underwent a wide surgical excision followed by chemotherapy and radiotherapy. About 15 months later, he experienced a pancreatic metastasis of his SS. He had a caudal splenopancreatectomy with partial resection of the transverse colon followed by chemotherapy. This report highlights the diagnostic difficulties of this rare localization and therapeutic challenge.

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