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Primary renal synovial sarcoma: A case report.

Huai-Jie Cai¹, Nan Cao¹, Wei Wang¹

¹The Fourth School of Clinical Medicine of Zhejiang Chinese Medical University, Hangzhou 310053, Zhejiang Province, China.

World Journal of Clinical Cases

|October 19, 2019

Summary

This summary is machine-generated.

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Primary renal synovial sarcoma (PRSS) is a rare, aggressive soft tissue tumor. Contrast-enhanced ultrasound revealed characteristic "slow in and fast out" hyperenhancement, aiding diagnosis, though chemotherapy showed limited effectiveness.

Area of Science:

Oncology
Pathology
Radiology

Background:

Synovial sarcoma is a rare mesenchymal tumor, typically near joints, but primary renal synovial sarcoma (PRSS) is exceptionally rare, comprising ~1% of synovial sarcomas.
PRSS is a highly malignant spindle cell tumor with potential epithelial differentiation, often affecting young adults and characterized by unclear histological origins.

Observation:

A 54-year-old male presented with a right renal mass identified via ultrasound and CT.
Imaging revealed a 6.8 cm cystic solid mass with irregular borders and internal vascularity.
Contrast-enhanced ultrasound (CEUS) demonstrated a distinctive "slow in and fast out" hyperenhancement pattern.

Findings:

Postoperative pathological diagnosis confirmed primary renal synovial sarcoma.

Keywords:

Case report Chemotherapy Renal synovial sarcoma Ultrasonic imaging

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Despite adjuvant chemotherapy, the patient experienced tumor recurrence within two years.

CEUS findings of "slow in and fast out" hyperenhancement may hold diagnostic value for PRSS.

Implications:

PRSS is a rare and aggressive malignancy with no pathognomonic imaging features currently established.
Diagnosis relies heavily on postoperative pathological examination, including immunohistochemistry and SS18 (SYT) gene analysis.
The observed CEUS characteristics suggest a potential role for this imaging modality in preoperative diagnosis, while highlighting the limited efficacy of current chemotherapy regimens.