Skip to main content

Advertisement

Log in

Pericardial synovial sarcoma: a case report and review of the literature

  • Case Report
  • Published:
Surgery Today Aims and scope Submit manuscript

Abstract

Primary pericardial synovial sarcoma is a rare disease. We herein report a case of synovial sarcoma that originated in the epicardium. A 13-year-old male visited our hospital with a fever and chest pain. Copious pericardial effusion and a large intrapericardial tumor were detected. An open-chest tumor resection was performed. A solid nodular tumor was observed in the pericardial cavity. The tumor was a polypoid mass that was pedunculated and grew from the inner surface of the pericardium near the origin of the SVC and ascending aorta. Histologically, the tumor cells were uniformly spindle shaped, with an ovoid or oval nucleus, and formed solid, compact sheets and fascicles. A storiform pattern was also observed. Based on the histopathological and immunohistochemical findings, and the fluorescence in situ hybridization detection of rearrangement of the SYT gene, a monophasic synovial sarcoma was diagnosed. We discuss the diagnosis and treatment of this case and review the pertinent literature.

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

Access this article

Subscribe and save

Springer+ Basic
EUR 32.99 /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
Fig. 3
Fig. 4

References

  1. Reynen K. Frequency of primary tumors of the heart. Am J Cardiol. 1996;77:107.

    Article  PubMed  CAS  Google Scholar 

  2. Takeda K, Masai T, Ishida M, Sunagawa G. Unusual presentation of multiple recurrent cardiac sarcomas as acute acalculous cholecystitis caused by rapid expansion into the right cardiac chamber: report of a case. Surg Today. 2012;42:479–81.

    Article  PubMed  Google Scholar 

  3. Burke AP, Virmani R. Primary cardiac sarcomas. In: Burke AP, Virmani R, editors. Tumors of the cardiovascular system Atlas of tumor pathology, third series. Washington: Armed Forces Institute of Pathology; 1996. p. 9–11.

    Google Scholar 

  4. Burke AP, Cowan D, Virmani R. Primary sarcomas of the heart. Cancer. 1992;69:387–95.

    Article  PubMed  CAS  Google Scholar 

  5. Nicholson AG, Goldstraw P, Fisher C. Synovial sarcoma of the pleura and its differentiation from other primary pleural tumours: a clinicopathological and immunohistochemical review of three cases. Histopathology. 1998;33:508–13.

    Article  PubMed  CAS  Google Scholar 

  6. 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;33:1743–51.

    Article  PubMed  Google Scholar 

  7. Sreekantaiah C, Ladanyi M, Rodriguez E, Chaganti RS. Chromosomal aberrations in soft tissue tumors: relevance to diagnosis, classification, and molecular mechanisms. Am J Pathol. 1994;144:1121–34.

    PubMed  CAS  PubMed Central  Google Scholar 

  8. Al-Rajhi N, Husain S, Coupland R, McNamee C, Jha N. Primary pericardial synovial sarcoma: a case report and literature review. J Surg Oncol. 1999;70:194–8.

    Article  PubMed  CAS  Google Scholar 

  9. Oizumi S, Igarashi K, Takenaka T, Yamashiro K, Hiraga H, Fujino T, et al. Primary pericardial synovial sarcoma with detection of the chimeric transcript SYT–SSX. Jpn Circ J. 1999;63:330–2.

    Article  PubMed  CAS  Google Scholar 

  10. Hing SN, Marshall L, Al-Saadi R, Hargrave D. Primary pericardial synovial sarcoma confirmed by molecular genetic studies: a case report. J Pediatr Hematol Oncol. 2007;29:492–5.

    Article  PubMed  CAS  Google Scholar 

  11. Katakura H, Fukuse T, Shiraishi I, Hayatsu E, Nishijo K, Toguchida J, et al. Mediastinal synovial sarcoma. Thorac Cardiovasc Surg. 2009;57:183–5.

    Article  PubMed  CAS  Google Scholar 

  12. Sun B, Sun Y, Wang J, Zhao X, Zhang S, Liu Y, et al. The diagnostic value of SYT–SSX detected by reverse transcriptase—polymerase chain reaction (RT-PCR) and fluorescence in situ hybridization (FISH) for synovial sarcoma: a review and prospective study of 255 cases. Cancer Sci. 2008;99:1355–61.

    Article  PubMed  CAS  Google Scholar 

  13. Thway K, Rockcliffe S, Gonzalez D, Swansbury J, Min T, Thompson L, et al. Utility of sarcoma—specific fusion gene analysis in paraffin-embedded material for routine diagnosis at a specialist centre. J Clin Pathol. 2010;63:508–12.

    Article  PubMed  CAS  Google Scholar 

  14. Guillou L, Benhattar J, Bonichon F, Gallagher G, Terrier P, Stauffer E, et al. Histologic grade, but not SYT–SSX fusion type, is an important prognostic factor in patients with synovial sarcoma: a multicenter, retrospective analysis. J Clin Oncol. 2004;22:4040–50.

    Article  PubMed  Google Scholar 

  15. Palmerini E, Staals EL, Alberghini M, Zanella L, Ferrari C, Benassi MS, et al. Synovial sarcoma: retrospective analysis of 250 patients treated at a single institution. Cancer. 2009;115:2988–98.

    Article  PubMed  Google Scholar 

  16. Van der Mieren G, Willems S, Sciot R, Dumez H, Van Oosterom A, Flameng W, et al. Pericardial synovial sarcoma: 14-year survival with multimodality therapy. Ann Thorac Surg. 2004;78:e41–2.

    Article  PubMed  Google Scholar 

  17. Okcu MF, Munsell M, Treuner J, Mattke A, Pappo A, Cain A, et al. Synovial sarcoma of childhood and adolescence: a multicenter, multivariate analysis of outcome. J Clin Oncol. 2003;21:1602–11.

    Article  PubMed  Google Scholar 

  18. Gu F, Ma Y, Fan Y, Lang R, Ding T, Hao X, et al. Synovial sarcoma individual chemotherapy directed by collagen gel droplet embedded culture drug sensitivity test: a case report. Oncol Lett. 2010;1:885–8.

    PubMed  PubMed Central  Google Scholar 

  19. McAllistar HA, Fenoglio JJ. Tumors of the cardiovascular system. In: Hartmann WH, editor. Atlas of tumour pathology, series 2. DC Armed Forces Institute of Pathology: Washington; 1978. p. 325–55.

    Google Scholar 

  20. Karn CM, Socinski MA, Fletcher JA, Corson JM, Craighead JE. Cardiac synovial sarcoma with translocation (X; 18) associated with asbestos exposure. Cancer. 1994;73:74–8.

    Article  PubMed  CAS  Google Scholar 

  21. Constantinou LL, Charitos CE, Lariou CM, Garyphalos DJ, Douras AL, Vichas GJ, et al. Primary synovial cardiac sarcoma: a rare cause of tamponade. Eur Heart J. 1996;17:1766–8.

    Article  PubMed  CAS  Google Scholar 

  22. Langner K, Schafer R, Muller KM, Goller T. Synovial sarcoma of the pericardium. Pathologe. 1998;19:442–6.

    Article  PubMed  CAS  Google Scholar 

  23. Kojima KY, Koslin DB, Primack SL, Kettler MD. Synovial sarcoma arising from the pericardium: radiographic and CT findings. AJR Am J Roentgenol. 1999;173:246–7.

    Article  PubMed  CAS  Google Scholar 

  24. Anand AK, Khanna A, Sinha SK, Mukherjee U, Walia JS, Singh AN. Pericardial synovial sarcoma. Clin Oncol (R Coll Radiol). 2003;15:186–8.

    Article  CAS  Google Scholar 

  25. Yano M, Toyooka S, Tsukuda K, Dote H, Morimoto Y, Ohata N, et al. SYT–SSX fusion genes in synovial sarcoma of the thorax. Lung Cancer. 2004;44:391–7.

    Article  PubMed  Google Scholar 

  26. Bégueret H, Galateau-Salle F, Guillou L, Chetaille B, Brambilla E, Vignaud JM, et al. Primary intrathoracic synovial sarcoma: a clinicopathologic study of 40 t(X;18)-positive cases from the French Sarcoma Group and the Mesopath Group. Am J Surg Pathol. 2005;29:339–46.

    Article  PubMed  Google Scholar 

  27. Schumann C, Kunze M, Kochs M, Hombach V, Rasche V. Pericardial synovial sarcoma mimicking pericarditis in findings of cardiac magnetic resonance imaging. Int J Cardiol. 2007;118:e83–4.

    Article  PubMed  CAS  Google Scholar 

  28. Korula A, Shah A, Philip MA, Kuruvila K, Pradhip J, Pai MC, et al. Primary mediastinal synovial sarcoma with transdiaphragmatic extension presenting as a pericardial effusion. Singapore Med J. 2009;50:e26–8.

    PubMed  CAS  Google Scholar 

  29. Moorjani N, Peebles C, Gallagher P, Tsang G. Pericardial synovial sarcoma. J Card Surg. 2009;24:349–51.

    Article  PubMed  Google Scholar 

  30. Yokouchi Y, Hiruta N, Oharaseki T, Ihara F, Oda Y, Ito S, et al. Primary cardiac synovial sarcoma: a case report and literature review. Pathol Int. 2011;61:150–5.

    Article  PubMed  Google Scholar 

  31. Cheng Y, Sheng W, Zhou X, Wang J. Pericardial synovial sarcoma, a potential for misdiagnosis: clinicopathologic and molecular cytogenetic analysis of three cases with literature review. Am J Clin Pathol. 2012;137:142–9.

    Article  PubMed  Google Scholar 

Download references

Conflict of interest

Yoshino M. and the co-authors have no conflicts of interest to declare in association with this study.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Yasuo Sekine.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Yoshino, M., Sekine, Y., Koh, E. et al. Pericardial synovial sarcoma: a case report and review of the literature. Surg Today 44, 2167–2173 (2014). https://doi.org/10.1007/s00595-013-0720-4

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00595-013-0720-4

Keywords

Navigation