Early progression of a pancreatic metastasis of synovial sarcoma after pancreatectomy
Abstract Background Synovial sarcoma is a malignant tumor that constitutes up to 10% of all soft-tissue sarcomas. The most frequent metastatic sites of synovial sarcoma are the lungs, lymph nodes, and bone, whereas pancreatic metastasis is extremely rare. Here, we report a case of pancreatic metasta...
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Japan Surgical Society
2023-02-01
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| Series: | Surgical Case Reports |
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| Online Access: | https://doi.org/10.1186/s40792-023-01612-z |
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| author | Mitsuyoshi Okazaki Kaoru Katano Hiroaki Sugita Tomokazu Tokoro Ryousuke Gabata Satoshi Takada Shinichi Nakanuma Isamu Makino Shintaro Yagi |
| author_facet | Mitsuyoshi Okazaki Kaoru Katano Hiroaki Sugita Tomokazu Tokoro Ryousuke Gabata Satoshi Takada Shinichi Nakanuma Isamu Makino Shintaro Yagi |
| author_sort | Mitsuyoshi Okazaki |
| collection | DOAJ |
| description | Abstract Background Synovial sarcoma is a malignant tumor that constitutes up to 10% of all soft-tissue sarcomas. The most frequent metastatic sites of synovial sarcoma are the lungs, lymph nodes, and bone, whereas pancreatic metastasis is extremely rare. Here, we report a case of pancreatic metastasis of synovial sarcoma. Case presentation Nine years before presentation, a 31-year-old woman underwent extensive resection of the primary tumor after chemotherapy for left upper extremity synovial sarcoma. Six months before presentation, interscapulothoracic amputation was performed for an enlarged mass in the left upper extremity; the patient was treated with pazopanib. Three months before presentation, chest computed tomography showed multiple lung metastases; during subsequent follow-up, abdominal computed tomography revealed a pancreatic metastasis of synovial sarcoma. The doubling time of the pancreatic tumor was 14 days, and it grew rapidly. Furthermore, treatment-resistant pancreatitis symptoms were detected; thus, we performed distal pancreatectomy and administered one course of a 70% dose of trabectedin. However, the patient died of rapid progression of lung metastasis and respiratory failure within 2 months after surgery. Conclusions Pancreatectomy may be carefully performed in cases of isolated pancreatic metastasis. However, the presence of other distant extrapancreatic metastases (e.g., uncontrolled lung metastases) may rule out pancreatectomy treatment. |
| format | Article |
| id | doaj-art-eea27bf2a5fa48c4bce64c240a3eb6fb |
| institution | DOAJ |
| issn | 2198-7793 |
| language | English |
| publishDate | 2023-02-01 |
| publisher | Japan Surgical Society |
| record_format | Article |
| series | Surgical Case Reports |
| spelling | doaj-art-eea27bf2a5fa48c4bce64c240a3eb6fb2025-08-20T03:22:22ZengJapan Surgical SocietySurgical Case Reports2198-77932023-02-01911810.1186/s40792-023-01612-zEarly progression of a pancreatic metastasis of synovial sarcoma after pancreatectomyMitsuyoshi Okazaki0Kaoru Katano1Hiroaki Sugita2Tomokazu Tokoro3Ryousuke Gabata4Satoshi Takada5Shinichi Nakanuma6Isamu Makino7Shintaro Yagi8Department of Hepato-Biliary-Pancreatic Surgery and Transplantation, Kanazawa UniversityDepartment of Hepato-Biliary-Pancreatic Surgery and Transplantation, Kanazawa UniversityDepartment of Hepato-Biliary-Pancreatic Surgery and Transplantation, Kanazawa UniversityDepartment of Hepato-Biliary-Pancreatic Surgery and Transplantation, Kanazawa UniversityDepartment of Hepato-Biliary-Pancreatic Surgery and Transplantation, Kanazawa UniversityDepartment of Hepato-Biliary-Pancreatic Surgery and Transplantation, Kanazawa UniversityDepartment of Hepato-Biliary-Pancreatic Surgery and Transplantation, Kanazawa UniversityDepartment of Hepato-Biliary-Pancreatic Surgery and Transplantation, Kanazawa UniversityDepartment of Hepato-Biliary-Pancreatic Surgery and Transplantation, Kanazawa UniversityAbstract Background Synovial sarcoma is a malignant tumor that constitutes up to 10% of all soft-tissue sarcomas. The most frequent metastatic sites of synovial sarcoma are the lungs, lymph nodes, and bone, whereas pancreatic metastasis is extremely rare. Here, we report a case of pancreatic metastasis of synovial sarcoma. Case presentation Nine years before presentation, a 31-year-old woman underwent extensive resection of the primary tumor after chemotherapy for left upper extremity synovial sarcoma. Six months before presentation, interscapulothoracic amputation was performed for an enlarged mass in the left upper extremity; the patient was treated with pazopanib. Three months before presentation, chest computed tomography showed multiple lung metastases; during subsequent follow-up, abdominal computed tomography revealed a pancreatic metastasis of synovial sarcoma. The doubling time of the pancreatic tumor was 14 days, and it grew rapidly. Furthermore, treatment-resistant pancreatitis symptoms were detected; thus, we performed distal pancreatectomy and administered one course of a 70% dose of trabectedin. However, the patient died of rapid progression of lung metastasis and respiratory failure within 2 months after surgery. Conclusions Pancreatectomy may be carefully performed in cases of isolated pancreatic metastasis. However, the presence of other distant extrapancreatic metastases (e.g., uncontrolled lung metastases) may rule out pancreatectomy treatment.https://doi.org/10.1186/s40792-023-01612-zSynovial sarcomaPancreatic metastasisPancreatectomy |
| spellingShingle | Mitsuyoshi Okazaki Kaoru Katano Hiroaki Sugita Tomokazu Tokoro Ryousuke Gabata Satoshi Takada Shinichi Nakanuma Isamu Makino Shintaro Yagi Early progression of a pancreatic metastasis of synovial sarcoma after pancreatectomy Surgical Case Reports Synovial sarcoma Pancreatic metastasis Pancreatectomy |
| title | Early progression of a pancreatic metastasis of synovial sarcoma after pancreatectomy |
| title_full | Early progression of a pancreatic metastasis of synovial sarcoma after pancreatectomy |
| title_fullStr | Early progression of a pancreatic metastasis of synovial sarcoma after pancreatectomy |
| title_full_unstemmed | Early progression of a pancreatic metastasis of synovial sarcoma after pancreatectomy |
| title_short | Early progression of a pancreatic metastasis of synovial sarcoma after pancreatectomy |
| title_sort | early progression of a pancreatic metastasis of synovial sarcoma after pancreatectomy |
| topic | Synovial sarcoma Pancreatic metastasis Pancreatectomy |
| url | https://doi.org/10.1186/s40792-023-01612-z |
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