Sarcomatoid malignant peritoneal mesothelioma: A rare case of sarcomatoid component with monosomy 9 appeared in ascites fluid

Noda, Yuri; Nakanishi, Yuko; Masuda, Kumi; Yamasaki, Masaru

doi:10.1016/j.ehpc.2019.200346

Cited by 1 publication

(2 citation statements)

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“…Soft tissue sarcomas account for <1.5% of all malignant neoplasms in adults. 14 An array of soft tissue sarcomas with Sarcomatoid mesothelioma Larger and less uniform nuclei, 2 single cells and loose aggregates, short spindle-shaped cells without microvilli 30 Calretinin, podoplanin (D2-40), WT1, CK5/6, mesothelin 31 Synovial sarcoma Mixed population of cohesive tissue fragments and scattered cells, tissue fragments contain thin branching capillaries, mitosis and mast cells present, sometimes admixed with epithelial-like structures 20,21 Epithelial membrane antigen, CK7, 24 CK19, 24 BCL2 (nearly 100% of synovial sarcoma cases), CD56 (nearly 100% of synovial sarcoma cases), 25 CD99 (60% of synovial sarcoma cases), 20 S100P (30% of synovial sarcoma cases), 20 TLE1(most sensitive and specific) 29 Cytogenetic analysis for detection of t(X;18)(p11.2;q11.2) translocation for confirmation of synovial sarcoma 24,28,32 musculoskeletal histology can occur in the abdomen and pelvis, posing challenging problems because of their complex anatomy and initial presentation as large masses with extensive invasion. Synovial sarcoma represents 5% to 10% of all soft tissue sarcomas.…”

Section: Discussionmentioning

confidence: 99%

“…The Table shows the differential diagnosis of synovial sarcoma in the pelvis. 2,18,20,21,[24][25][26][27][28][29][30][31][32] Immunohistochemically, the spindle cell population of synovial sarcoma can show focal or widespread positivity for epithelial membrane antigen (most sensitive) and for CK7 and CK19, which are nearly 100% specific. 24 Hartel et al found that BCL2 and CD56 reach nearly 100% positivity in cases of primary pulmonary and mediastinal synovial sarcoma, 25 and approximately 60% of synovial sarcoma are positive for CD99.…”

Section: Gupta Dmentioning

confidence: 99%

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Pelvic Synovial Sarcoma Clinically Masquerading as an Ovarian Malignancy

Gupta

Nalwa

Vedant

et al. 2022

TOJ

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Background: Synovial sarcoma, a malignant mesenchymal tumor, commonly involves the extremities and is rarely found in the pelvis. Cytology with a biphasic pattern can suggest the diagnosis of synovial sarcoma. Case Report: A 32-year-old female presented with complaints of abdominal distension. She was initially evaluated in another hospital where she underwent ultrasound-guided fine needle aspiration cytology (FNAC) of the abdominal mass. The mass was diagnosed as ovarian adenocarcinoma, and the patient underwent 3 cycles of chemotherapy. After 3 months, she was referred to our institute for surgical excision of the mass. Contrast-enhanced computed tomography of the abdomen suggested a wellcircumscribed, heterogeneous, solid-cystic mass in the left adnexal region measuring 13.9 × 10 × 9.1 cm and compressing the adjacent structures. No previous radiologic investigations were available. We reviewed the FNAC slide from the outside hospital and made a preliminary diagnosis of biphasic synovial sarcoma. The patient underwent debulking surgery consisting of panhysterectomy with excision of the pelvic mass. Microscopic examination of the pelvic mass showed a biphasic tumor composed of epithelial and mesenchymal components, suggestive of synovial sarcoma. The immunohistochemistry profile supported the morphologic diagnosis. Bilateral ovaries were unremarkable. The patient received 4 cycles of adjuvant chemotherapy and is presently asymptomatic. Conclusion: Although primary pelvic synovial sarcoma is a rare occurrence, this case illustrates that synovial sarcoma can be diagnosed or at least suspected on FNAC. Because of the importance of adjuvant chemotherapy, synovial sarcoma must be high on the list of differential diagnoses of high-grade intra-abdominal masses.

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