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Related Experiment Videos

Myxoid synovial sarcoma: an underappreciated morphologic subset.

J F Krane1, F Bertoni, C D Fletcher

  • 1Department of Pathology, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts 02115, USA.

Modern Pathology : an Official Journal of the United States and Canadian Academy of Pathology, Inc
|June 1, 1999
PubMed
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This study highlights myxoid synovial sarcoma, a rare variant that can be misdiagnosed. Early recognition is crucial for appropriate treatment of this challenging soft tissue sarcoma.

Area of Science:

  • Oncology
  • Pathology
  • Histology

Background:

  • Focal myxoid change is common in synovial sarcoma, but a predominantly myxoid stroma is rare.
  • This rare histologic variant can be mistaken for other myxoid spindle cell neoplasms, potentially leading to suboptimal therapy.

Purpose of the Study:

  • To describe seven cases of myxoid synovial sarcoma.
  • To emphasize the diagnostic challenges and importance of recognizing this variant.

Main Methods:

  • Histopathological examination of seven cases with marked myxoid stroma.
  • Immunohistochemical analysis including epithelial membrane antigen, pan-keratin, S-100, and CD99.
  • Clinical follow-up data analysis for recurrence and metastasis.

Main Results:

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  • Cases presented with predominantly myxoid stroma, sometimes obscuring diagnosis.
  • Histology showed monophasic spindle cell lesions with areas of typical synovial sarcoma features and occasional biphasic differentiation.
  • Immunohistochemistry revealed characteristic markers, though S-100 and CD99 showed variable positivity.
  • Clinical follow-up indicated potential for local recurrence and distant metastasis.

Conclusions:

  • Myxoid synovial sarcoma is a rare variant that requires careful histologic and immunohistochemical evaluation.
  • Distinguishing it from other myxoid spindle cell tumors is critical for appropriate patient management.
  • Further studies are needed to determine if clinical behavior differs from conventional synovial sarcoma.