Testicular Synovial Sarcoma: A Case Report

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...

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Bibliographic Details
Published inCancer biology & medicine Vol. 9; no. 3; p. 274
Main Authors Mejri Nesrine, Sellami, Rym, Doghri, Raoudha, Rifi, Hela, Raies, Henda, Mezlini, Amel
Format Journal Article
LanguageEnglish
Published Tianjin Chinese Anti-Cancer Association (CACA), Cancer Biology & Medicine 01.09.2012
Subjects
Biopsy
Cell proliferation
Chemotherapy
Computed tomography
Differential diagnosis
Dyspnea
Effusion
Gemcitabine
Genetic analysis
Ifosfamide
Lymph nodes
Medical prognosis
Metastases
Nodules
Orchidectomy
Paclitaxel
Pain
Prognosis
Radiation therapy
Respiration
Synovial sarcoma
Testes
Ultrasonography
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Summary: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 confi rmed 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 plural 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.
ISSN:2095-3941