Primary synovial sarcoma of the kidney

Area of Science:

• Oncology
• Pathology

Background:

• Primary synovial sarcoma (SS) of the kidney is an exceedingly rare renal neoplasm.
• It presents a significant diagnostic challenge, often being mistaken for more common renal malignancies.

Observation:

• A 60-year-old male presented with clinical suspicion of renal cell carcinoma.
• A large, well-circumscribed renal mass measuring 13 cm × 9 cm × 7 cm was surgically resected.
• The mass exhibited a tawny, firm cut surface with cystic degeneration, hemorrhage, and necrosis.

Findings:

• Histological examination revealed a tumor composed of spindle cells in intersecting fascicles, consistent with monophasic synovial sarcoma.
• Immunohistochemical analysis confirmed the morphological findings, supporting the diagnosis of SS of the kidney.

Implications:

• Accurate diagnosis of primary renal synovial sarcoma is crucial for appropriate patient management.
• This case underscores the need for comprehensive histopathological evaluation in rare renal tumors.
• Recognizing SS of the kidney aids in differentiating it from renal cell carcinoma and other sarcomas.