A rare synovial sarcoma of the spine in the thoracic vertebral body

Abstract

Primary vertebral body synovial sarcoma is very rare and difficult to diagnose and treat.

Primary Intraosseous Synovial Sarcoma with Molecular Confirmation: Expanding and Clarifying the Spectrum of This Rare Neoplasm

“…Rarely, primary bone synovial sarcoma may appear deceptively benign [7]. By MRI scan, intraosseous synovial sarcomas are typically isointense to hypointense on T1-weighted images and hyperintense on T2-weighted images [6][7][8]11]. In both of our cases, the tumors were primarily lytic lesions centered in and primarily localized to the bone, with ill-defined margins.…”

“…Adding to this controversy, synovial sarcoma has been documented as arising in a variety of anatomic sites, including but not limited to the lung and pleura [25][26][27][28][29], heart and pericardium [30,31], kidney [12, 32-37], prostate [38], and gastrointestinal tract [39][40][41][42][43]. Regarding connective tissues, synovial sarcoma may have its origins within intramuscular [44], para-articular [23], intraneural [45][46][47], or intraosseous tissues [2][3][4][5][6][7][8][9][10][11]. For the above reasons, some have proposed renaming synovial sarcoma as "carcinosarcoma of connective tissue," reflecting the concept of true epithelial differentiation in association with a spindle cell sarcoma and the absence of true synovial differentiation [48,49].…”

“…Eleven of 13 patients (84.6%) had relevant reported clinical management data regarding their initial presentation, and 9 (69.2%) had reported clinical follow-up data. Of 11 patients, 6 (54.5%) reportedly received adjuvant or neoadjuvant chemotherapy [3,4,8,10,11]. In 5 of 6 cases, the chemotherapy regimen was disclosed [4,8,10,11].…”

“…Of 11 patients, 6 (54.5%) reportedly received adjuvant or neoadjuvant chemotherapy [3,4,8,10,11]. In 5 of 6 cases, the chemotherapy regimen was disclosed [4,8,10,11]. Four of 5 patients received ifosfamide and/or doxorubicin as part of their chemotherapy regimen: 3 patients received both chemotherapeutic agents (1 additionally received dacarbazine) and 1 patient received doxorubicin with olaratumab [4,10,11].…”

“…The appendicular skeleton, especially the long bones of the lower extremities, is far more commonly involved than the axial skeleton. Specific primary sites of involvement have included the tibia (5 cases) [2][3][4][5], ulna (2) [6,7], radius (1) [8], fibula (1) [9], femur (1) [10], and thoracic spine (1) [11]. An additional 26 reported cases, lacking molecular or cytogenetic confirmation of the diagnosis, are also identifiable within the English-language literature Table 2), some of which may not represent "true" synovial sarcomas [12][13][14][15][16][17][18][19][20][21][22].…”