Skip to main content

Advertisement

Log in

Synovial sarcoma of the spinal canal and paraspinal muscle and retroperitoneum: a case with extensive calcification

  • Case Report
  • Published:
Child's Nervous System Aims and scope Submit manuscript

Abstract

Introduction

Synovial sarcoma (SS) is a rare mesenchymal malignant tumor. SS of the spine or retroperitoneum is an extremely rare site. Approximately 30% cases show focal calcifications on radiographs and computed tomography (CT) images, while extensive calcification rarely occurs. We presented a case of SS involving the spinal canal and paraspinal muscle and retroperitoneum, which showed extensive calcification on CT.

Clinical presentation

The present report describes the case of a 13-year-old girl suffering from a tumor in the spinal canal and paraspinal muscle and retroperitoneum with extensive calcification on CT. The patient underwent lumbar and retroperitoneal giant tumor resection, lumbar decompression, and spinal tumor resection with a small tumor remnant remaining in the paravertebral region. Histological examination and genetic testing after surgery confirmed synovial sarcoma. After surgery, the patient refused local radiotherapy but agreed to receive chemotherapy. After 4 months of follow-up, her condition was basically stable, and the pain in her left lower limb disappeared. The residual tumor was not increased.

Conclusion

Extensive calcification of SS is rare. The possibility of synovial sarcoma should be considered in those who show extensive calcification in the spinal canal and paraspinal muscle and retroperitoneum on CT. For cases that cannot be completely resected, adjuvant chemotherapy can control the residual tumor in the short term. In addition, the long-term effects need to be observed.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Subscribe and save

Springer+ Basic
$34.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or eBook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Subramanian S, Jonathan GE, Patel B, Prabhu K (2020) Synovial sarcoma mimicking a thoracic dumbell schwannoma- a case report. Br J Neurosurg 34(1):1–4. https://doi.org/10.1080/02688697.2017.1418289

    Article  Google Scholar 

  2. Ishida H, Fujino T, Taguchi R, Nitanda H, Sakaguchi H, Yanagihara A, Yoshimura R (2019) Primary pulmonary synovial sarcoma with calcification: a case report. Thoracic Cancer 10(10):2040–2044. https://doi.org/10.1111/1759-7714.13172

    Article  PubMed  PubMed Central  Google Scholar 

  3. Chatzipantelis P, Kafiri G (2008) Retroperitoneal synovial sarcoma: a clinicopathological study of 6 cases. J BUON 13(2):211–216

    CAS  PubMed  Google Scholar 

  4. Suh SI, Seol HY, Hong SJ, Kim JH, Kim JH, Lee JH, Kim MG (2005) Spinal epidural synovial sarcoma: a case of homogeneous enhancing large paravertebral mass on MR imaging. AJNR Am J Neuroradiol 26(9):2402–2405

    PubMed  PubMed Central  Google Scholar 

  5. Ud Din N, Hopkins A, Memon A, Ahmad Z, Ahmed R (2015) Calcifying/ossifying synovial sarcoma: a clinicopathologic and molecular study of 5 cases. Indian J Pathol Microbiol 8(1):55–58. https://doi.org/10.4103/0377-4929.151188

    Article  Google Scholar 

  6. Milchgrub S, Ghandur-Mnaymneh L, Dorfman HD, Albores-Saavedra J (1993) Synovial sarcoma with extensive osteoid and bone formation. Am J Surg Pathol 17(4):357–363. https://doi.org/10.1097/00000478-199304000-00006

    Article  CAS  PubMed  Google Scholar 

  7. Kim J, Lee SH, Choi YL, Bae GE, Kim ES, Eoh W (2014) Synovial sarcoma of the spine: a case involving paraspinal muscle with extensive calcification and the surgical consideration in treatment. Eur Spine J 23(1):27–31. https://doi.org/10.1007/s00586-013-3034-8

    Article  PubMed  Google Scholar 

  8. Khin T, Cyril F (2014) Synovial sarcoma: defining features and diagnostic evolution. Ann Diagn Pathol 18(6):369–380. https://doi.org/10.1016/j.anndiagpath.2014.09.002

    Article  Google Scholar 

  9. Suster S, Fisher C, Moran CA (1998) Expression of bcl-2 oncoprotein in benign and malignant spindle cell tumors of soft tissue, skin, serosal surfaces, and gastrointestinal tract. Am J Surg Pathol 22(7):863–872. https://doi.org/10.1097/00000478-199807000-00008

    Article  CAS  PubMed  Google Scholar 

  10. Fisher C (1998) Synovial sarcoma. Ann Diagn Pathol 2(6):401–421. https://doi.org/10.1016/s1092-9134(98)80042-7

    Article  CAS  PubMed  Google Scholar 

  11. Fisher C, Montgomery E, Healy V (2003) Calponin and h-caldesmon expression in synovial sarcoma; the use of calponin in diagnosis. Histopathology 42(6):588–593. https://doi.org/10.1046/j.1365-2559.2003.01652.x

    Article  CAS  PubMed  Google Scholar 

  12. Murphey MD, Gibson MS, Jennings BT, Crespo-Rodríguez AM, Fanburg-Smith J, Gajewski DA (2006) From the archives of the AFIP: imaging of synovial sarcoma with radiologic-pathologic correlation. Radiographics 26(5):1543–1565. https://doi.org/10.1148/rg.265065084

    Article  PubMed  Google Scholar 

  13. Liang C, Mao H, Tan J, Ji Y, Sun F, Dou W, Wang H, Wang H, Gao J (2015) Synovial sarcoma: magnetic resonance and computed tomography imaging features and differential diagnostic considerations. Oncol Lett 9(2):661–666. https://doi.org/10.3892/ol.2014.2774

    Article  PubMed  Google Scholar 

  14. Treu EB, de Slegte RG, Golding RP, Sperber M, van Zanten TE, Valk J (1986) CT findings in paravertebral synovial sarcoma. J Comput Assist Tomogr 10(3):460–462

    CAS  PubMed  Google Scholar 

  15. Balik MS, Erkut A, Guvercin Y, Bedir R (2016) Synovial sarcoma mimicking myositis ossificans. Knee Surg Relat Res 28(3):249–252. https://doi.org/10.5792/ksrr.2016.28.3.249

    Article  PubMed  PubMed Central  Google Scholar 

  16. Jones BC, Sundaram M, Kransdorf MJ (1993) Synovial sarcoma: MR imaging findings in 34 patients. Ajr Am J Roentgenol 161(4):827–830. https://doi.org/10.2214/ajr.161.4.8396848

    Article  CAS  PubMed  Google Scholar 

  17. Tateishi U, Hasegawa T, Beppu Y, Satake M, Moriyama N (2004) Synovial sarcoma of the soft tissues: prognostic significance of imaging features. J Comput Assist Tomogr 28(1):140–148. https://doi.org/10.1097/00004728-200401000-00024

    Article  PubMed  Google Scholar 

  18. Rafailidis V, Kaziani T, Theocharides C, Papanikolaou A, Rafailidis D (2014) Imaging of the malignant peripheral nerve sheath tumour with emphasis οn ultrasonography: correlation with MRI. J Ultrasound 17(3):219–223. https://doi.org/10.1007/s40477-014-0097-2

    Article  PubMed  PubMed Central  Google Scholar 

  19. Yu YH, Wu JT, Ye J, Chen MX (2016) Radiological findings of malignant peripheral nerve sheath tumor: reports of six cases and review of literature. World J Surg Oncol 14:142. https://doi.org/10.1186/s12957-016-0899-0

    Article  PubMed  PubMed Central  Google Scholar 

  20. Pan W, Feng B, Wang Z, Lin N, Ye Z (2017) Malignant peripheral nerve sheath tumor in the paraspinal region mimicking a benign peripheral nerve sheath tumor: a case report. Eur Spine J 26(Suppl 1):90–94. https://doi.org/10.1007/s00586-016-4787-7

    Article  PubMed  Google Scholar 

  21. Beltir G, Arikan SM, Ates OF, Gungor BS (2018) Giant cervical chondrosarcoma. Ulutas Med J 4(2):118–123. https://doi.org/10.5455/umj.20180119064908

    Article  Google Scholar 

  22. Prevedello DM, Cordeiro JG, Koerbel A, Ditzel LF, Araújo JC (2004) Management of primary spinal chondrosarcoma: report of two cases causing cord compression. Arq Neuropsiquiatr 62(3B):875–878. https://doi.org/10.1590/s0004-282x2004000500026

    Article  PubMed  Google Scholar 

  23. Hekmatnia A, Ghazavi A, Aminmansour B, Mahzouni P (2012) A case of chondrosarcoma that primarily developed in the cervical spine. Iran J Radiol 9(1):57–59. https://doi.org/10.5812/iranjradiol.6344

    Article  PubMed  PubMed Central  Google Scholar 

  24. Sakayama K, Kawatani Y, Kidani T, Sugawara Y, Miyazaki T, Fujibuchi T, Yamamoto H (2004) Dumbbell-shaped chondrosarcoma that primarily developed in the cervical spine: a case report. J Orthop Sci 9(2):166–170. https://doi.org/10.1007/s00776-003-0756-1

    Article  PubMed  Google Scholar 

  25. Liu G, Wu G, Ghimire P, Pang H, Zhang Z (2013) Primary spinal chondrosarcoma: radiological manifestations with histopathological correlation in eight patients and literature review. Clin Imaging 37(1):124–133. https://doi.org/10.1016/j.clinimag.2012.02.010

    Article  PubMed  Google Scholar 

  26. El Beaino M, Araujo DM, Lazar AJ, Lin PP (2017) Synovial sarcoma: advances in diagnosis and treatment identification of new biologic targets to improve multimodal therapy. Ann Surg Oncol 24(8):2145–2154. https://doi.org/10.1245/s10434-017-5855-x

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Mingyue Meng.

Ethics declarations

Conflict of interest

None

Additional information

Publisher’s note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Zhang, G., Fang, G. & Meng, M. Synovial sarcoma of the spinal canal and paraspinal muscle and retroperitoneum: a case with extensive calcification. Childs Nerv Syst 37, 3913–3917 (2021). https://doi.org/10.1007/s00381-021-05145-4

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00381-021-05145-4

Keywords

Navigation