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Testicular synovial sarcoma: a case report.

Nesrine M, Sellami R, Doghri R, Rifi H, Raies H, Mezlini A - Cancer Biol Med (2012)

Bottom Line: After 3 months, the patient developed local recurrence and pulmonary metastases that did not respond to second-line chemotherapy based on gemcitabine and paclitaxel.This patient died on November 16, 2012 after a resperatory failure and malignant pelural effusion.Although our patient has shown numerous factors of bad prognosis, he has had a relatively long survival time.

View Article: PubMed Central - PubMed

Affiliation: Department of Medical Oncology, Salah Azaeiz Institute, Tunis 1006, Tunisia.

ABSTRACT
This paper reports a case of testicular synovial sarcoma with molecular genetic analysis. A 24-year-old male presented with painless scrotal mass. Ultrasonography showed a heterogeneous mass of 66 mm × 34 mm in size involving the inguinal region. Histological examination of a surgical biopsy showed a grade III monophasic growth pattern of spindle cell proliferation. Immunohistochemical analyses indicated positive staining for pancytokeratine and epithelial membrane antigen. Cytogenetic analysis showed the presence of CYT-SSX1 mutation, and CT scan showed non-specific pleural micro-nodules with a size of 7.5 mm. The patient had an extended left orchidectomy but was lost to follow-up for 1 year. A local recurrent scrotal mass of 32 mm × 25 mm, multiple inguinal lymph nodes, and increased pleural nodules, which were confirmed by histological examination, were treated with three cycles of adriamycine and ifosfamide chemotherapy, surgical resection, and radiotherapy with complete response. After 3 months, the patient developed local recurrence and pulmonary metastases that did not respond to second-line chemotherapy based on gemcitabine and paclitaxel. The patient had dyspnea at the time of this writing and chest pain, and is under third-line chemotherapy based on Deticene after 30 months of following up. This patient died on November 16, 2012 after a resperatory failure and malignant pelural effusion. Synovial sarcoma should be considered in the differential diagnosis of soft tissue tumor and it should be aggressively treated to improve prognosis. Although our patient has shown numerous factors of bad prognosis, he has had a relatively long survival time.

No MeSH data available.


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Pancytokeratine positive staining (IHC staning, ×40).
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f2: Pancytokeratine positive staining (IHC staning, ×40).

Mentions: In April 2010, a 24-year-old man presented with painless left testicular swelling without infection or trauma history. Clinical examination showed a firm mobile mass with a size of 62 mm × 40 mm and no palpable inguinal lymph nodes were found. He had no relevant past medical history. Scrotal ultrasonography revealed a large heterogeneous testicular mass of 66 mm × 34 mm in size in the inguinal region. Abdominal ultrasonography showed no other lesions. B human chronic gonadotrophin and α-fetoprotein levels were normal. The patient underwent surgical biopsy. Histological examination indicated a monophasic growth pattern of spindle cells (Figure 1). Tumor cells exhibited a hyperchromatic round or oval nucleus with features of atypia. Numerous mitoses were seen (25 mitoses/10 fields of high magnification). This proliferation infiltrated the paratesticular tunics with features of vascular emboli. Immunohistochemical analysis showed focally positive staining for pancytokeratine AE1/AE3 (Figure 2) and epithelial membrane antigen (EMA) (Figure 3). Negative results were seen with CD34, PS100, c-Kit, and desmine. Proliferative index was 60%. The tumor was classified as monophasic poorly differentiated synovial sarcoma; grade III according to the National Federation of Centers Against Cancer. A molecular biology analysis seeking t (X;18) detected the characteristic fusion transcript of SYT-SSX 1.


Testicular synovial sarcoma: a case report.

Nesrine M, Sellami R, Doghri R, Rifi H, Raies H, Mezlini A - Cancer Biol Med (2012)

Pancytokeratine positive staining (IHC staning, ×40).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3643673&req=5

f2: Pancytokeratine positive staining (IHC staning, ×40).
Mentions: In April 2010, a 24-year-old man presented with painless left testicular swelling without infection or trauma history. Clinical examination showed a firm mobile mass with a size of 62 mm × 40 mm and no palpable inguinal lymph nodes were found. He had no relevant past medical history. Scrotal ultrasonography revealed a large heterogeneous testicular mass of 66 mm × 34 mm in size in the inguinal region. Abdominal ultrasonography showed no other lesions. B human chronic gonadotrophin and α-fetoprotein levels were normal. The patient underwent surgical biopsy. Histological examination indicated a monophasic growth pattern of spindle cells (Figure 1). Tumor cells exhibited a hyperchromatic round or oval nucleus with features of atypia. Numerous mitoses were seen (25 mitoses/10 fields of high magnification). This proliferation infiltrated the paratesticular tunics with features of vascular emboli. Immunohistochemical analysis showed focally positive staining for pancytokeratine AE1/AE3 (Figure 2) and epithelial membrane antigen (EMA) (Figure 3). Negative results were seen with CD34, PS100, c-Kit, and desmine. Proliferative index was 60%. The tumor was classified as monophasic poorly differentiated synovial sarcoma; grade III according to the National Federation of Centers Against Cancer. A molecular biology analysis seeking t (X;18) detected the characteristic fusion transcript of SYT-SSX 1.

Bottom Line: After 3 months, the patient developed local recurrence and pulmonary metastases that did not respond to second-line chemotherapy based on gemcitabine and paclitaxel.This patient died on November 16, 2012 after a resperatory failure and malignant pelural effusion.Although our patient has shown numerous factors of bad prognosis, he has had a relatively long survival time.

View Article: PubMed Central - PubMed

Affiliation: Department of Medical Oncology, Salah Azaeiz Institute, Tunis 1006, Tunisia.

ABSTRACT
This paper reports a case of testicular synovial sarcoma with molecular genetic analysis. A 24-year-old male presented with painless scrotal mass. Ultrasonography showed a heterogeneous mass of 66 mm × 34 mm in size involving the inguinal region. Histological examination of a surgical biopsy showed a grade III monophasic growth pattern of spindle cell proliferation. Immunohistochemical analyses indicated positive staining for pancytokeratine and epithelial membrane antigen. Cytogenetic analysis showed the presence of CYT-SSX1 mutation, and CT scan showed non-specific pleural micro-nodules with a size of 7.5 mm. The patient had an extended left orchidectomy but was lost to follow-up for 1 year. A local recurrent scrotal mass of 32 mm × 25 mm, multiple inguinal lymph nodes, and increased pleural nodules, which were confirmed by histological examination, were treated with three cycles of adriamycine and ifosfamide chemotherapy, surgical resection, and radiotherapy with complete response. After 3 months, the patient developed local recurrence and pulmonary metastases that did not respond to second-line chemotherapy based on gemcitabine and paclitaxel. The patient had dyspnea at the time of this writing and chest pain, and is under third-line chemotherapy based on Deticene after 30 months of following up. This patient died on November 16, 2012 after a resperatory failure and malignant pelural effusion. Synovial sarcoma should be considered in the differential diagnosis of soft tissue tumor and it should be aggressively treated to improve prognosis. Although our patient has shown numerous factors of bad prognosis, he has had a relatively long survival time.

No MeSH data available.


Related in: MedlinePlus