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Cystic synovial sarcoma.

C Morrison¹, P E Wakely, C J Ashman

¹Department of Pathology, Ohio State University, Columbus, OH 43210, USA.

Annals of Diagnostic Pathology

|February 15, 2001

Summary

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This case study describes a rare paraspinal synovial sarcoma with extensive cystic changes. Advanced imaging and diagnostic techniques aided in identifying this unusual soft tissue tumor.

Area of Science:

Oncology
Pathology
Radiology

Background:

Synovial sarcoma is a rare soft tissue malignancy.
Paraspinal tumors can present with diverse imaging characteristics.
Cystic changes in soft tissue tumors can complicate diagnosis.

Observation:

A 53-year-old woman presented with a paraspinal mass exhibiting significant cystic degeneration.
Magnetic resonance imaging revealed a heterogeneous, multilocular mass with hemorrhage.
Histopathology confirmed a biphasic synovial sarcoma with glandular and spindle cell components and multiple cysts.

Findings:

Immunohistochemistry showed distinct markers for both glandular (cytokeratin, EMA) and spindle cell (cytokeratin, vimentin, bcl-2, CD99) components.
Cytogenetic analysis identified a characteristic t(X;18) translocation.

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The tumor displayed extensive cystic formation within the paraspinal soft tissues.

Implications:

Synovial sarcoma should be included in the differential diagnosis of cystic soft tissue lesions.
Magnetic resonance imaging is crucial for evaluating soft tissue tumors, offering diagnostic clues.
Immunohistochemistry and cytogenetics are vital for accurate diagnosis of atypical presentations.