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Primary cutaneous synovial sarcoma: a case report

D B Flieder1, C A Moran

  • 1Department of Pulmonary and Mediastinal Pathology, Armed Forces Institute of Pathology, Washington, DC 20306-6000, USA.

The American Journal of Dermatopathology
|October 28, 1998
PubMed
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This case study details a rare synovial sarcoma in a young woman's knee. The tumor exhibited aggressive behavior with multiple recurrences over 24 years.

Area of Science:

  • Oncology
  • Dermatopathology
  • Surgical Pathology

Background:

  • Synovial sarcoma is a rare soft tissue malignancy typically arising in deep connective tissues.
  • Cutaneous involvement is exceptionally uncommon, presenting diagnostic challenges.

Observation:

  • An 18-year-old female presented with a recurrent 2.5 cm cutaneous tumor on the knee.
  • Histopathology revealed a biphasic tumor with spindle cells and epithelial nests, involving deep dermis and superficial subcutis.
  • Immunohistochemistry showed vimentin, CAM 5.2, and epithelial membrane antigen expression in spindle cells and epithelial nests.

Findings:

  • The tumor demonstrated aggressive behavior with six recurrences over 24 years post-excision.
  • Morphological heterogeneity included myxoid and hemangiopericytoma-like areas with mast cells.

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  • Negative staining for desmin, S-100, CD-31, and CD-34 aided in differential diagnosis.

    • Implications:

    • This case highlights synovial sarcoma as a rare differential diagnosis for cutaneous knee neoplasms.
    • The tumor's unique location and heterogeneous morphology necessitate careful clinicopathological correlation.
    • Understanding this presentation is crucial for accurate diagnosis and management of rare cutaneous sarcomas.