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Pelvic Synovial Sarcoma Clinically Masquerading as an Ovarian Malignancy
Deepika Gupta1, Aasma Nalwa1, Deepak Vedant1
1Department of Pathology and Laboratory Medicine, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India.
Ochsner Journal
|March 20, 2023
Summary
Primary pelvic synovial sarcoma is rare but can be suspected via fine needle aspiration cytology (FNAC). Early diagnosis is crucial for appropriate adjuvant chemotherapy in high-grade abdominal masses.
Area of Science:
- Oncology
- Pathology
- Surgical Oncology
Background:
- Synovial sarcoma is a rare malignant mesenchymal tumor, typically affecting extremities.
- Pelvic synovial sarcoma is exceptionally rare, posing diagnostic challenges.
- Biphasic pattern on cytology can suggest synovial sarcoma.
Observation:
- A 32-year-old female presented with abdominal distension and a large pelvic mass.
- Initial fine needle aspiration cytology (FNAC) misdiagnosed the mass as ovarian adenocarcinoma.
- Review of FNAC slides at a specialized institute suggested biphasic synovial sarcoma.
Findings:
- Contrast-enhanced CT revealed a large, complex left adnexal mass.
- Surgical excision confirmed a biphasic tumor consistent with synovial sarcoma.
- Immunohistochemistry supported the diagnosis of synovial sarcoma.
Implications:
- This case highlights the importance of considering synovial sarcoma in the differential diagnosis of intra-abdominal masses.
- FNAC can be instrumental in suspecting or diagnosing synovial sarcoma.
- Accurate diagnosis is critical for initiating timely and appropriate adjuvant chemotherapy.
