Primary pancreatic synovial sarcoma: Report of a rare case and review of the literature

Ali,Rebaz M.; Seerwan,Karzan; Ali,Shano M.; Abdullah,Ari M.; Hawrami,Omar; Hussein,Dlsoz M.; Mohammed,Bruj Jamil; Karim,Muhammad; Abdullah,Fakher; Abdalla,Berun A.; Kakamad,Fahmi H.

doi:10.3892/mi.2023.82

Primary pancreatic synovial sarcoma: Report of a rare case and review of the literature

Authors:
- Rebaz M. Ali
- Karzan Seerwan
- Shano M. Ali
- Ari M. Abdullah
- Omar Hawrami
- Dlsoz M. Hussein
- Bruj Jamil Mohammed
- Muhammad Karim
- Fakher Abdullah
- Berun A. Abdalla
- Fahmi H. Kakamad
View Affiliations

Affiliations: Deparment of Oncology, Hiwa Hospital, Sulaimani, Kurdistan 46000, Iraq, College of Medicine, University of Sulaimani, Sulaimani, Kurdistan 46000, Iraq, Department of Pathology, Sulaimani Teaching Hospital, Sulaimani, Kurdistan 46000, Iraq, Department of Scientific Affairs, Smart Health Tower, Sulaimani, Kurdistan 46000, Iraq, Kscien Organization for Scientific Research (Middle East Office), Sulaimani, Kurdistan 46000, Iraq
Published online on: March 24, 2023 https://doi.org/10.3892/mi.2023.82
Article Number: 22
Copyright: © Ali et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

Metrics: Total Views: 0 (Spandidos Publications: | PMC Statistics: )

Metrics: Total PDF Downloads: 0 (Spandidos Publications: | PMC Statistics: )

Cited By (CrossRef): 0 citations Loading Articles...

Abstract

Synovial sarcoma is a mesenchymal spindle cell tumor. Primary pancreatic sarcomas are extremely rare. The present study describes a rare case of synovial sarcoma in the head of the pancreas. A 35‑year‑old male presented with left upper quadrant abdominal pain. An endoscopic ultrasound examination revealed a complex solid‑cystic lesion in the pancreatic head. He had undergone pancreaticoduodenectomy (Whipple procedure). A histological examination yielded negative results for AE1/AE3, CD10, S100, CD34, desmin, smooth muscle actin, β‑catenin, CD117, HMB45, chromogranin and synaptophysin. However, the results were positive for TLEI and vimentin, which is consistent with synovial sarcoma. Synovial sarcoma is a soft tissue malignant tumor. Primary pancreatic sarcomas frequently present as large, high‑grade tumors in the pancreatic head. Histologically, there are several types of synovial sarcoma, such as monophasic, biphasic and poorly differentiated. A histological examination is necessary for the diagnosis as the imaging findings are not specifically suggestive of synovial sarcoma. The preferred course of treatment is complete resection with wide margins, followed by adjuvant chemotherapy and/or radiotherapy. Primary mesenchymal tumors of the pancreas are extremely uncommon. As a result, a diagnosis requires careful evaluation. Surgical resection is the main modality of treatment.

View Figures

View References

1	Makino Y, Shigekawa M, Kegasawa T, Suda T, Yoshioka T, Iwahashi K, Ikezawa K, Sakamori R, Yakushijin T, Kajihara J, et al: A case report of pancreatic metastasis from synovial sarcoma successfully treated by metastasectomy with adjuvant chemotherapy. Medicine (Baltimore). 95(e4789)2016.PubMed/NCBI View Article : Google Scholar
2	Sahara S, Otsuki Y, Egawa Y, Shimizu S, Yoshizawa Y, Hosoda Y, Suzuki K, Sato Y and Kobayashi H: Primary synovial sarcoma of the stomach-a case report and review of the literature. Pathol Res Pract. 209:745–750. 2013.PubMed/NCBI View Article : Google Scholar
3	Nagaraju S, Grethlein SJ, Vaishnav S, Sharfuddin AA, Powelson JA and Fridell JA: Case report: Primary de novo sarcoma in transplant pancreas allograft. Transplant Proc. 49:2352–2354. 2017.PubMed/NCBI View Article : Google Scholar
4	Luc G, Collet D, Reich S, Stanislas S and Sa-Cunha A: Primary monophasic synovial sarcoma of the pancreas. J Visc Surg. 150:159–161. 2013.PubMed/NCBI View Article : Google Scholar
5	Malek B, Saida S, Olfa J, Salma K, Maher S, Riadh C and Khaled R: The management of pancreatic metastasis from synovial sarcoma of the soft tissue: A case report. Rare Tumors. 12(2036361320983691)2020.PubMed/NCBI View Article : Google Scholar
6	Srinivasan VD, Wayne JD, Rao MS and Zynger DL: Solitary fibrous tumor of the pancreas: Case report with cytologic and surgical pathology correlation and review of the literature. JOP. 9:526–530. 2008.PubMed/NCBI
7	Kiefer ED: Carcinoma of the pancreas. Arch Int Med. 40:1–29. 1927.
8	Owen CH, Madden JF and Clavien PA: Spindle cell stromal tumor of the pancreas: Treatment by pancreatoduodenectomy. Surgery. 122:105–111. 1997.PubMed/NCBI View Article : Google Scholar
9	Youngwirth LM, Freischlag K, Nussbaum DP, Benrashid E and Blazer DG: Primary sarcomas of the pancreas: A review of 253 patients from the National Cancer Data Base. Surg Oncol. 27:676–680. 2018.PubMed/NCBI View Article : Google Scholar
10	Kim JY, Song JS, Park H, Byun JH, Song KB, Kim KP, Kim SC and Hong SM: Primary mesenchymal tumors of the pancreas: Single-center experience over 16 years. Pancreas. 43:959–968. 2014.PubMed/NCBI View Article : Google Scholar
11	Baranov E, McBride MJ, Bellizzi AM, Ligon AH, Fletcher CDM, Kadoch C and Hornick JL: A novel SS18-SSX fusion-specific antibody for the diagnosis of synovial sarcoma. Am J Surg Pathol. 44:922–933. 2020.PubMed/NCBI View Article : Google Scholar
12	Takenaka S, Ueda T, Naka N, Araki N, Hashimoto N, Myoui A, Ozaki T, Nakayama T, Toguchida J, Tanaka K, et al: Prognostic implication of SYT-SSX fusion type in synovial sarcoma: A multi-institutional retrospective analysis in Japan. Oncol Rep. 19:467–476. 2008.PubMed/NCBI
13	Foo WC, Cruise MW, Wick MR and Hornick JL: Immunohistochemical staining for TLE1 distinguishes synovial sarcoma from histologic mimics. Am J Clin Pathol. 135:839–844. 2011.PubMed/NCBI View Article : Google Scholar
14	Tanaka M, Homme M, Yamazaki Y, Ae K, Matsumoto S, Subramanian S and Nakamura T: Cooperation between SS18-SSX1 and miR-214 in synovial sarcoma development and progression. Cancers (Basel). 12(324)2020.PubMed/NCBI View Article : Google Scholar
15	Zhang H, Jensen MH, Farnell MB, Smyrk TC and Zhang L: Primary leiomyosarcoma of the pancreas: study of 9 cases and review of literature. Am J Surg Pathol. 34:1849–1856. 2010.PubMed/NCBI View Article : Google Scholar
16	Ferrari A, Gronchi A, Casanova M, Meazza C, Gandola L, Collini P, Lozza L, Bertulli R, Olmi P and Casali PG: Synovial sarcoma: A retrospective analysis of 271 patients of all ages treated at a single institution. Cancer. 101:627–634. 2004.PubMed/NCBI View Article : Google Scholar
17	Spillane AJ, A'Hern R, Judson IR, Fisher C and Thomas JM: Synovial sarcoma: A clinicopathologic, staging, and prognostic assessment. J Clin Oncol. 18:3794–3803. 2000.PubMed/NCBI View Article : Google Scholar
18	Guillou L, Benhattar J, Bonichon F, Gallagher G, Terrier P, Stauffer E, Somerhausen Nde S, Michels JJ, Jundt G, Vince DR, et al: Histologic grade, but not SYT-SSX fusion type, is an important prognostic factor in patients with synovial sarcoma: A multicenter, retrospective analysis. J Clin Oncol. 22:4040–4050. 2004.PubMed/NCBI View Article : Google Scholar
19	Trovik LH, Ovrebo K, Almquist M, Haugland HK, Rissler P, Eide J, Engellau J, Monge OR, Nyhus AB, Elde IK and Jebsen NL: Adjuvant radiotherapy in retroperitoneal sarcomas. A scandinavian sarcoma group study of 97 patients. Acta Oncol. 53:1165–1172. 2014.PubMed/NCBI View Article : Google Scholar