Korean J Pathol.  2012 Apr;46(2):187-191.

Primary Monophasic Synovial Sarcoma Arising in the Mesentery: Case Report of an Extremely Rare Mesenteric Sarcoma Confirmed by Molecular Detection of a SYT-SSX2 Fusion Transcript

• Ryu HS
• Heo I
• Koh JS
• Jin SH
• Kang HJ
• Cho SY

Abstract

Synovial sarcoma arises in the para-articular tissues, and it can also occur in various unexpected sites. We report a rare case of primary monophasic synovial sarcoma (MSS) arising in the mesentery. A 59-year-old man presented with a palpable abdominal mass. On microscopic examination, the entire tumor comprised a dense proliferation of the spindle cells without epithelial components. The tumor cells were positive for transducin-like enhancer of split 1, bcl-2, epithelial membrane antigen and CD99 but negative for CD34, CD117, alpha-smooth muscle actin, cytokeratin, and calretinin on immunohistochemistry. The reverse transcriptase-polymerase chain reaction revealed a single 151-bp fragment representing the SYT-SSX2 fusion transcript. Because mesenteric MSS is extremely rare and many cases display histologic findings that overlap with those of more frequently involved tumors such as hemangiopericytoma and gastrointestinal stromal tumor, there is a chance of making an incorrect diagnosis that can result in an inappropriate treatment.

Keyword

Synovial sarcoma; Mesentery; Spindle cell sarcoma; Immunohistochemistry; Reverse transcriptase polymerase chain reaction

MeSH Terms

Actins
Calcium-Binding Protein, Vitamin D-Dependent
Gastrointestinal Stromal Tumors
Hemangiopericytoma
Humans
Immunohistochemistry
Keratins
Mesentery
Middle Aged
Mucin-1
Muscles
Oncogene Proteins, Fusion
Reverse Transcriptase Polymerase Chain Reaction
Sarcoma
Sarcoma, Synovial
Actins
Calcium-Binding Protein, Vitamin D-Dependent
Keratins
Mucin-1
Oncogene Proteins, Fusion