Synovial sarcoma mimicking benign peripheral nerve sheath tumor

Area of Science:

• Oncology
• Radiology
• Pathology

Background:

• Peripheral nerve tumors are common, with benign peripheral nerve sheath tumors being the most frequent.
• Synovial sarcoma of the nerve is a rare entity that can present with similar clinical and imaging features to benign peripheral nerve sheath tumors.

Purpose of the Study:

• To evaluate the clinicopathologic and radiographic characteristics of nerve synovial sarcoma.
• To differentiate nerve synovial sarcoma from benign peripheral nerve sheath tumors.

Main Methods:

• Retrospective review of five patients with nerve synovial sarcoma initially diagnosed as benign peripheral nerve sheath tumors.
• Analysis of clinical, imaging (MRI), and histopathologic features.
• Comparison with a cohort of benign peripheral nerve sheath tumors.

Main Results:

• Nerve synovial sarcoma presented as heterogeneous, enhancing soft tissue masses on MRI, contiguous with the neurovascular bundle.
• Histologically, most were monophasic synovial sarcoma.
• All patients achieved complete remission with no evidence of disease after surgery.

Conclusions:

• Primary nerve synovial sarcoma can mimic benign peripheral nerve sheath tumors clinically and radiographically.
• It should be included in the differential diagnosis for peripheral nerve tumors.