Synovial sarcoma of the cauda equina
Ikuho Yonezawa1, Tsuyoshi Saito, Daishi Nakahara
1Department of Orthopaedic Surgery, Juntendo University School of Medicine, Tokyo, Japan. yoza@juntendo.ac.jp
Journal of Neurosurgery. Spine
|November 22, 2011
Summary
This study reports a rare case of primary synovial sarcoma in the cauda equina of a 23-year-old woman. Complete surgical resection and radiation therapy led to a favorable long-term outcome without recurrence.
Area of Science:
- Oncology
- Neurosurgery
- Molecular Diagnostics
Background:
- Primary synovial sarcoma of the cauda equina is exceptionally rare, with limited documented cases.
- Synovial sarcoma is a soft tissue sarcoma characterized by specific chromosomal translocations.
Observation:
- A 23-year-old woman presented with a 2-month history of low-back pain.
- MRI revealed an intradural, extramedullary mass from L3-L4.
- Physical examination showed moderate motor weakness in bilateral extensor hallux longus muscles.
Findings:
- Histopathological and molecular analysis confirmed synovial sarcoma via SYT-SSX fusion transcripts.
- Complete tumor resection followed by adjuvant radiation therapy was performed.
- The patient remained disease-free with no local recurrence or metastasis at 5.5-year follow-up.
Implications:
- This case highlights the importance of molecular diagnostics, specifically RT-PCR for SYT-SSX fusion, in diagnosing rare spinal tumors.
- Successful management involved a multimodal approach combining surgical resection and adjuvant radiotherapy.
- Early diagnosis and comprehensive treatment are crucial for favorable prognoses in patients with cauda equina synovial sarcoma.
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