期刊论文详细信息
BMC Research Notes
Synovial sarcoma presenting with huge mediastinal mass: a case report and review of literature
Maysa Al-Hussaini1  Amal Daboor1  Akram Al-Ibraheem3  Samer Salah2 
[1] Department of pathology and laboratory medicine, King Hussein cancer center, Amman, Jordan;Department of medical oncology, King Hussein cancer center, Amman, Jordan;Department of radiology, nuclear imaging division, King Hussein cancer center, Amman, Jordan
关键词: Surgical resection;    Chemotherapy;    Synovial sarcoma;    Mediastinal mass;   
Others  :  1142382
DOI  :  10.1186/1756-0500-6-240
 received in 2012-10-08, accepted in 2013-06-19,  发布年份 2013
PDF
【 摘 要 】

Background

Synovial sarcoma presenting in the mediastinum is exceedingly rare. Furthermore, data addressing optimal therapy is limited. Herein we present a case where an attempt to downsize the tumor to a resectable state with chemotherapy was employed.

Case presentation

A 32 year female presented with massive pericardial effusion and unresectable huge mediastinal mass. Computed axial tomography scan - guided biopsy with adjunctive immunostains and molecular studies confirmed a diagnosis of synovial sarcoma. Following three cycles of combination Ifosfamide and doxorubicin chemotherapy, no response was demonstrated. The patient refused further therapy and had progression of her disease 4 months following the last cycle.

Conclusion

Synovial sarcoma presenting with unresectable mediastinal mass carry a poor prognosis. Up to the best of our knowledge there are only four previous reports where primary chemotherapy was employed, unfortunately; none of these cases had subsequent complete surgical resection. Identification of the best treatment strategy for patients with unresectable disease is warranted. Our case can be of benefit to medical oncologists and thoracic surgeons who might be faced with this unique and exceedingly rare clinical scenario.

【 授权许可】

   
2013 Salah et al.; licensee BioMed Central Ltd.

【 预 览 】
附件列表
Files Size Format View
20150328042326881.pdf 3064KB PDF download
Figure 2. 89KB Image download
Figure 1. 94KB Image download
【 图 表 】

Figure 1.

Figure 2.

【 参考文献 】
  • [1]Salter DM: Pulmonary and thoracic sarcomas. Curr Diagn Pathol 2006, 12:409-417.
  • [2]Ducimetière F, Lurkin A, Ranchère-Vince D, Decouvelaere AV, Péoc'h M, Istier L, Chalabreysse P, Muller C, Alberti L, Bringuier PP, Scoazec JY, Schott AM, Bergeron C, Cellier D, Blay JY, Ray-Coquard I: Incidence of sarcoma histotypes and molecular subtypes in a prospective epidemiological study with central pathology review and molecular testing. PLoS One 2011, 6(8):e20294.
  • [3]Paquette M, Truong PT, Hart J, Jones SO, Martens B, Christie JL, Alexander C, Joe H: Primary sarcoma of the mediastinum: a report of 16 cases referred to the British Columbia cancer agency. J Thorac Oncol 2010, 5(6):898-906.
  • [4]Nakagawa Y, Shimizu T, Terakado M, Hiranuma H, Matsumoto K, Takahashi N, Hashimoto S: A case of synovial sarcoma of the mediastinum. Nihon Kokyuki Gakkai Zasshi 2010, 48(10):734-738.
  • [5]Arafah M, Zaidi SN: Poorly differentiated monophasic synovial sarcoma of the mediastinum. Indian J Pathol Microbiol 2011, 54(2):384-387.
  • [6]Gladish GW, Sabloff BM, Munden RF, Truong MT, Erasmus JJ, Chasen MH: Primary thoracic sarcomas. Radiographics 2002, 22:621-637.
  • [7]Eilber FC, Dry SM: Diagnosis and management of synovial sarcoma. J Surg Oncol 2008, 97(4):314-320.
  • [8]Rossi S, Nascimento AG, Canal F, Dei Tos AP: Small round-cell neoplasms of soft tissues: an integrated diagnostic approach. Curr Diagn Pathol 2007, 13:150-163.
  • [9]Miettinen M, Limon J, Niezabitowski A, Lasota J: Patterns of keratin polypeptides in 110 biphasic, monophasic, and poorly differentiated synovial sarcomas. Virchows Arch 2000, 437(3):275-283.
  • [10]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(10):1060-1065.
  • [11]Jagdis A, Rubin BP, Tubbs RR, Pacheco M, Nielsen TO: Prospective evaluation of TLE1 as a diagnostic immunohistochemical marker in synovial sarcoma. Am J Surg Pathol 2009, 33(12):1743-1751.
  • [12]Cormier JN, Pollock RE: Soft tissue sarcomas. CA Cancer J Clin 2004, 54:94-109.
  • [13]Turc-Carel C, Dal Cin P, Limon J, Li F, Sandberg AA: Translocation X;18 in synovial sarcoma. Cancer Genet Cytogenet 1986, 23(1):93.
  • [14]Morgan SS, Cranmer LD: Systematic therapy for unresectable or metastatic soft-tissue sarcomas: past, present, and future. Curr Oncol Rep 2011, 13(4):331-349.
  • [15]Pratt CB, Maurer HM, Gieser P, Salzberg A, Rao BN, Parham D, Thomas PR, Marcus RB, Cantor A, Pick T, Green D, Neff J, Jenkins JJ: Treatment of unresectable or metastatic pediatric soft tissue sarcomas with surgery, irradiation, and chemotherapy: a pediatric oncology group study. Med Pediatr Oncol 1998, 30(4):201-209.
  • [16]Van der Mieren G, Willems S, Sciot R, Dumez H, Van Oosterom A, Flameng W, Herijgers P: Pericardial synovial sarcoma: 14-year survival with multimodality therapy. Ann Thorac Surg 2004, 78(3):e41-e42.
  • [17]Ravikumar G, Mullick S, Ananthamurthy A, Correa M: Primary synovial sarcoma of the mediastinum: a case report. Case Rep Surg 2011, 2011:602853.
  • [18]Suster S, Moran CA: Primary synovial sarcomas of the mediastinum: a clinicopathologic, immunohistochemical, and ultrastructural study of 15 cases. Am J Surg Pathol 2005, 29(5):569-578.
  文献评价指标  
  下载次数:33次 浏览次数:24次