Primary synovial sarcoma of the kidney-A case report and literature review

Primary synovial sarcoma of the kidney is a very rare spindle cell neoplasm that occasionally displays epithelial differentiation. It occurs between 15-60 years of age with a mean of 35 years and a slight male predilection. Most of synovial sarcomas appear as relatively nonspecific soft tissue masses involving the kidney. This rare entity has some overlapping morphologic and immunohistochemical characteristics with other more common renal spindle cell neoplasms. Molecular tools add valuable diagnostic confirmation. We report a 56 year old male who presented to the emergency department with hematuria and abdominal pain. He had an abdominal CT-scan which showed a 6.6 cm enhancing right renal mass. Morphologic and immunohistochemical studies were directed towards synovial sarcoma with confirmation by SYT-SSX gene fusion using RT-PCR molecular technique. We reviewed the literature on the epidemiologic, histologic spectrum, immunophenotypic, clinical significance and prognosis and therapy.