Primary Intracranial Synovial Sarcoma

Background. Synovial sarcoma is an aggressive soft tissue sarcoma with uncertain histological origin. The pathology frequently presents as a localized disease, especially near large joints around the knee and thigh. Intracranial disease, which is rare, has been reported as metastasis from synovial s...

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Main Authors: Mohit Patel, Luyuan Li, Ha Son Nguyen, Ninh Doan, Grant Sinson, Wade Mueller
Format: Article
Language:English
Published: Wiley 2016-01-01
Series:Case Reports in Neurological Medicine
Online Access:http://dx.doi.org/10.1155/2016/5608315
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author Mohit Patel
Luyuan Li
Ha Son Nguyen
Ninh Doan
Grant Sinson
Wade Mueller
author_facet Mohit Patel
Luyuan Li
Ha Son Nguyen
Ninh Doan
Grant Sinson
Wade Mueller
author_sort Mohit Patel
collection DOAJ
description Background. Synovial sarcoma is an aggressive soft tissue sarcoma with uncertain histological origin. The pathology frequently presents as a localized disease, especially near large joints around the knee and thigh. Intracranial disease, which is rare, has been reported as metastasis from synovial sarcoma. We report a case with no obvious primary extracranial pathology, suggesting primary intracranial disease; this has not been reported in the literature. Case Description. A 21-year-old male, with a prior right skull lesion resection for atypical spindle cell neoplasm, presented with headaches, gait instability, left arm weakness, and left homonymous hemianopsia. CT of head demonstrated a right parietal hemorrhagic lesion with mass effect, requiring surgical decompression. Histopathology revealed synovial sarcoma. FISH analysis noted the existence of the t(X;18)(p11.2;q11.2) chromosomal translocation. PET scan did not show other metastatic disease. He underwent stereotactic radiotherapy and adjuvant chemotherapy. At 2-year follow-up, he remained nonfocal without recurrence. Conclusion. We report the first known case of primary intracranial synovial sarcoma. Moreover, we stress that intracranial lesions may have a tendency for hemorrhage, requiring urgent lifesaving decompression.
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spelling doaj-art-89d3c743315440b1b8a78fb3971e57d92025-08-20T02:09:19ZengWileyCase Reports in Neurological Medicine2090-66682090-66762016-01-01201610.1155/2016/56083155608315Primary Intracranial Synovial SarcomaMohit Patel0Luyuan Li1Ha Son Nguyen2Ninh Doan3Grant Sinson4Wade Mueller5Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, WI 53226, USADepartment of Neurosurgery, Medical College of Wisconsin, Milwaukee, WI 53226, USADepartment of Neurosurgery, Medical College of Wisconsin, Milwaukee, WI 53226, USADepartment of Neurosurgery, Medical College of Wisconsin, Milwaukee, WI 53226, USADepartment of Neurosurgery, Medical College of Wisconsin, Milwaukee, WI 53226, USADepartment of Neurosurgery, Medical College of Wisconsin, Milwaukee, WI 53226, USABackground. Synovial sarcoma is an aggressive soft tissue sarcoma with uncertain histological origin. The pathology frequently presents as a localized disease, especially near large joints around the knee and thigh. Intracranial disease, which is rare, has been reported as metastasis from synovial sarcoma. We report a case with no obvious primary extracranial pathology, suggesting primary intracranial disease; this has not been reported in the literature. Case Description. A 21-year-old male, with a prior right skull lesion resection for atypical spindle cell neoplasm, presented with headaches, gait instability, left arm weakness, and left homonymous hemianopsia. CT of head demonstrated a right parietal hemorrhagic lesion with mass effect, requiring surgical decompression. Histopathology revealed synovial sarcoma. FISH analysis noted the existence of the t(X;18)(p11.2;q11.2) chromosomal translocation. PET scan did not show other metastatic disease. He underwent stereotactic radiotherapy and adjuvant chemotherapy. At 2-year follow-up, he remained nonfocal without recurrence. Conclusion. We report the first known case of primary intracranial synovial sarcoma. Moreover, we stress that intracranial lesions may have a tendency for hemorrhage, requiring urgent lifesaving decompression.http://dx.doi.org/10.1155/2016/5608315
spellingShingle Mohit Patel
Luyuan Li
Ha Son Nguyen
Ninh Doan
Grant Sinson
Wade Mueller
Primary Intracranial Synovial Sarcoma
Case Reports in Neurological Medicine
title Primary Intracranial Synovial Sarcoma
title_full Primary Intracranial Synovial Sarcoma
title_fullStr Primary Intracranial Synovial Sarcoma
title_full_unstemmed Primary Intracranial Synovial Sarcoma
title_short Primary Intracranial Synovial Sarcoma
title_sort primary intracranial synovial sarcoma
url http://dx.doi.org/10.1155/2016/5608315
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AT luyuanli primaryintracranialsynovialsarcoma
AT hasonnguyen primaryintracranialsynovialsarcoma
AT ninhdoan primaryintracranialsynovialsarcoma
AT grantsinson primaryintracranialsynovialsarcoma
AT wademueller primaryintracranialsynovialsarcoma