A minute primary gastric synovial sarcoma with ulcer: a case report.


Journal

Diagnostic pathology
ISSN: 1746-1596
Titre abrégé: Diagn Pathol
Pays: England
ID NLM: 101251558

Informations de publication

Date de publication:
13 Dec 2021
Historique:
received: 23 07 2021
accepted: 22 11 2021
entrez: 13 12 2021
pubmed: 14 12 2021
medline: 16 3 2022
Statut: epublish

Résumé

Synovial sarcomas are a rare type of high-grade sarcomas with unknown cell origin. They arise predominantly in the soft tissues but rarely in the stomach. We recently encountered a rare case of minute gastric synovial sarcoma. A 61-year-old Japanese woman was pointed out edematous erosion at the body of the stomach. Biopsy specimen showed dense proliferation of spindle-shaped tumor cells mixed with smooth muscle fibers of the muscularis mucosae. Although the definite histological diagnosis was undetermined, the patient underwent laparoscopic wedge resection of the stomach. Histological examination of the resected sample revealed that the maximum diameter of the tumor was only 6 mm and that dense proliferation of rather uniform spindle tumor cells were observed mainly in the submucosa. Immunohistochemistry showed that they were positive for pan-keratin, CD99 and TLE1. SS18-SSX fusion-specific antibody gave diffuse positive staining to the tumor cells, and analysis using mRNA extracted from paraffin sections revealed that the tumor had SS18-SSX1 fusion gene. Thus, it was diagnosed as gastric synovial sarcoma, monophasic fibrous type. Primary synovial sarcoma of the stomach is rare and only 47 cases have been reported in the English literature to date. The maximum diameter of the lesion of our case was 6 mm which is the smallest among them.

Sections du résumé

BACKGROUND BACKGROUND
Synovial sarcomas are a rare type of high-grade sarcomas with unknown cell origin. They arise predominantly in the soft tissues but rarely in the stomach. We recently encountered a rare case of minute gastric synovial sarcoma.
CASE PRESENTATION METHODS
A 61-year-old Japanese woman was pointed out edematous erosion at the body of the stomach. Biopsy specimen showed dense proliferation of spindle-shaped tumor cells mixed with smooth muscle fibers of the muscularis mucosae. Although the definite histological diagnosis was undetermined, the patient underwent laparoscopic wedge resection of the stomach. Histological examination of the resected sample revealed that the maximum diameter of the tumor was only 6 mm and that dense proliferation of rather uniform spindle tumor cells were observed mainly in the submucosa. Immunohistochemistry showed that they were positive for pan-keratin, CD99 and TLE1. SS18-SSX fusion-specific antibody gave diffuse positive staining to the tumor cells, and analysis using mRNA extracted from paraffin sections revealed that the tumor had SS18-SSX1 fusion gene. Thus, it was diagnosed as gastric synovial sarcoma, monophasic fibrous type.
CONCLUSIONS CONCLUSIONS
Primary synovial sarcoma of the stomach is rare and only 47 cases have been reported in the English literature to date. The maximum diameter of the lesion of our case was 6 mm which is the smallest among them.

Identifiants

pubmed: 34895269
doi: 10.1186/s13000-021-01175-3
pii: 10.1186/s13000-021-01175-3
pmc: PMC8667358
doi:

Substances chimiques

Biomarkers, Tumor 0
Oncogene Proteins, Fusion 0
SYT-SSX fusion protein 0

Types de publication

Case Reports

Langues

eng

Sous-ensembles de citation

IM

Pagination

115

Informations de copyright

© 2021. The Author(s).

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Auteurs

Kanako Yoshiyasu (K)

Department of Surgical Pathology, Hyogo College of Medicine, 1-1 Mukogawacho, 663-8501, Nishinomiya, Hyogo, Japan.

Hiroshi Kono (H)

Department of Surgical Pathology, Hyogo College of Medicine, 1-1 Mukogawacho, 663-8501, Nishinomiya, Hyogo, Japan.

Yudai Hojo (Y)

Upper Gastrointestinal Division, Department of Surgery, Hyogo College of Medicine, 1-1 Mukogawacho, 663-8501, Nishinomiya, Hyogo, Japan.

Yoshinori Ishida (Y)

Upper Gastrointestinal Division, Department of Surgery, Hyogo College of Medicine, 1-1 Mukogawacho, 663-8501, Nishinomiya, Hyogo, Japan.

Akio Tamura (A)

Division of Gastroenterology and Hepatology, Department of Internal Medicine, Hyogo College of Medicine, 1-1 Mukogawacho, 663-8501, Nishinomiya, Hyogo, Japan.

Keisuke Nakai (K)

Division of Gastroenterology and Hepatology, Department of Internal Medicine, Hyogo College of Medicine, 1-1 Mukogawacho, 663-8501, Nishinomiya, Hyogo, Japan.

Tadayuki Oshima (T)

Division of Gastroenterology and Hepatology, Department of Internal Medicine, Hyogo College of Medicine, 1-1 Mukogawacho, 663-8501, Nishinomiya, Hyogo, Japan.

Hiroto Miwa (H)

Division of Gastroenterology and Hepatology, Department of Internal Medicine, Hyogo College of Medicine, 1-1 Mukogawacho, 663-8501, Nishinomiya, Hyogo, Japan.

Hisashi Shinohara (H)

Upper Gastrointestinal Division, Department of Surgery, Hyogo College of Medicine, 1-1 Mukogawacho, 663-8501, Nishinomiya, Hyogo, Japan.

Seiichi Hirota (S)

Department of Surgical Pathology, Hyogo College of Medicine, 1-1 Mukogawacho, 663-8501, Nishinomiya, Hyogo, Japan. hiros@hyo-med.ac.jp.

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Classifications MeSH