Primary cardiac synovial sarcoma: A case report and literature review
Corresponding Author
Yuki Yokouchi
Departments of Surgical Pathology
Yuki Yokouchi, MD, Department of Surgical Pathology, Toho University Ohashi Medical Center, 2-17-6, Ohashi, Meguro-ku, Tokyo, 153-8515, Japan. Email: [email protected]Search for more papers by this authorNobuyuki Hiruta
Department of Surgical Pathology, Toho University Sakura Medical Center, Chiba
Search for more papers by this authorYoshinao Oda
Department of Anatomic Pathology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
Search for more papers by this authorTatsuya Gomi
Radiology, Toho University Ohashi Medical Center, Tokyo
Search for more papers by this authorCorresponding Author
Yuki Yokouchi
Departments of Surgical Pathology
Yuki Yokouchi, MD, Department of Surgical Pathology, Toho University Ohashi Medical Center, 2-17-6, Ohashi, Meguro-ku, Tokyo, 153-8515, Japan. Email: [email protected]Search for more papers by this authorNobuyuki Hiruta
Department of Surgical Pathology, Toho University Sakura Medical Center, Chiba
Search for more papers by this authorYoshinao Oda
Department of Anatomic Pathology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
Search for more papers by this authorTatsuya Gomi
Radiology, Toho University Ohashi Medical Center, Tokyo
Search for more papers by this authorAbstract
Primary cardiac synovial sarcoma is a rare disease. A 51-year-old man visited our hospital with the chief complaint of palpitations and shortness of breath while exercising. Copious bloody pericardial effusion and a multicystic intrapericardial tumor were detected. A primary cardiac malignant tumor was suspected, an open-chest tumor resection was performed with the objectives of diagnosis and treatment. Histologically, the tumor cells were uniformly spindle-shaped with an ovoid or oval nucleus, they had proliferated in fascicular fashion. In addition myxoid degeneration, a hemangiopericytomatous vascular pattern and pseudorosette formation were seen in some areas of the tumor. Based on the histopathological and immunohistochemical findings and reverse transcription polymerase chain reaction detection of SS18-SSX1 fusion transcripts, a monophasic fibrous type synovial sarcoma was diagnosed. Postoperative radiation therapy was administered and there had been no recurrence 9 months after the surgery.
REFERENCES
- 1 Burke AP, Virmani R. Primary cardiac sarcomas. In: AP Burke, R Virmani, eds. Tumors of the Cardiovascular System. Atlas of Tumor Pathology, Third Series. Washington, DC: Armed Forces Institute of Pathology, 1996; 9–11.
- 2 Weiss SW, Goldblum JR. Synovial sarcoma. In: SW Weiss, JR Goldblum, FM Enzinger, eds. Soft Tissue Tumors, 4th edn. St. Louis, MO: Mosby, 2001; 1483–509.
- 3 Miettinen M, Limon J, Niezabitowski A, Lasota J. Calretinin and other mesothelioma markers in synovial sarcoma: Analysis of antigenic similarities and differences with malignant mesothelioma. Am J Surg Pathol 2001; 25: 610–17.
- 4 Nicholson AG, Goldstraw P, Fisher C. Synovial sarcoma of the pleura and its differentiation from other primary pleural tumours: A clinicopathological and immunohistochemical review of three cases. Histopathology 1998; 33: 508–13.
- 5 Weinbreck N, Vignaud JM, Begueret H et al. SYT-SSX fusion is absent in sarcomatoid mesothelioma allowing its distinction from synovial sarcoma of the pleura. Mod Pathol 2007; 20: 617–21.
- 6 McAllistar HA, Fenoglio JJ. Tumors of the cardiovascular system. In: WH Hartmann, ed. Atlas of Tumour Pathology, Series 2. Washington, DC: Armed Forces Institute of Pathology, 1978; 325–55.
- 7 Sheffield EA, Corrin B, Addis BJ, Gelder C. Synovial sarcoma of the heart arising from a so-called mesothelioma of the atrio-ventricular node. Histopathology 1988; 12: 191–201.
- 8 Siebenmann R, Jenni R, Makek M, Oelz O, Turina M. Primary synovial sarcoma of the heart treated by heart transplantation. J Thorac Cardiovasc Surg 1990; 99: 567–8.
- 9
Burke AP,
Cowan D,
Virmani R.
Primary sarcomas of the heart.
Cancer
1992; 69: 387–95.
10.1002/1097-0142(19920115)69:2<387::AID-CNCR2820690219>3.0.CO;2-N CAS PubMed Web of Science® Google Scholar
- 10
Karn CM,
Socinski MA,
Fletcher JA,
Corson JM,
Craighead JE.
Cardiac synovial sarcoma with translocation (X;18) associated with asbestos exposure.
Cancer
1994; 73: 74–8.
10.1002/1097-0142(19940101)73:1<74::AID-CNCR2820730114>3.0.CO;2-I CAS PubMed Web of Science® Google Scholar
- 11 Iyengar V, Lineberger AS, Kerman S, Burton NA. Synovial sarcoma of the heart. Correlation with cytogenetic findings. Arch Pathol Lab Med 1995; 119: 1080–82.
- 12
Konstantinou LL,
Charitos CE,
Lariou CM
et al.
Primary synovial cardiac sarcoma: A rare cause of tamponade.
Eur Heart J
1996; 17: 1766–8.
10.1093/oxfordjournals.eurheartj.a014778 Google Scholar
- 13 Nicholson AG, Rigby M, Lincoln C, Meller S, Fisher C. Synovial sarcoma of the heart. Histopathology 1997; 30: 349–52.
- 14 Langner K, Schafer R, Muller KM, Goller T. Synovial sarcoma of the pericardium. Pathologe 1998; 19: 442–6.
- 15
Al-Rajhi N,
Husain S,
Coupland R,
McNamee C,
Jha N.
Primary pericardial synovial sarcoma: A case report and literature review.
J Surg Oncol
1999; 70: 194–8.
10.1002/(SICI)1096-9098(199903)70:3<194::AID-JSO10>3.0.CO;2-8 CAS PubMed Web of Science® Google Scholar
- 16 Kojima KY, Koslin DB, Primack SL, Kettler MD. Synovial sarcoma arising from the pericardium: Radiographic and CT findings. AJR Am J Roentgenol 1999; 173: 246–7.
- 17 Oizumi S, Igarashi K, Takenaka T et al. Primary pericardial synovial sarcoma with detection of the chimeric transcript SYT-SSX. Jpn Circ J 1999; 63: 330–32.
- 18 Donsbeck AV, Ranchere D, Coindre JM, Le Gall F, Cordier JF, Loire R. Primary cardiac sarcomas: An immunohistochemical and grading study with long-term follow-up of 24 cases. Histopathology 1999; 34: 295–304.
- 19 Casselman FP, Gillinov AM, Kasirajan V, Ratliff NB, Cosgrove DM 3rd. Primary synovial sarcoma of the left heart. Ann Thorac Surg 1999; 68: 2329–31.
- 20 Bittira B, Tsang J, Huynh T, Morin JF, Hüttner I. Primary right atrial synovial sarcoma manifesting as transient ischemic attacks. Ann Thorac Surg 2000; 69: 1949–51.
- 21 Anand AK, Khanna A, Sinha SK, Mukherjee U, Walia JS, Singh AN. Pericardial synovial sarcoma. Clin Oncol (R Coll Radiol) 2003; 15: 186–8.
- 22 McGilbray TT, Schulz TK. Clinical picture: Primary cardiac synovial sarcoma. Lancet Oncol 2003; 4: 283.
- 23 Van der Mieren G, Willems S, Sciot R et al. Pericardial synovial sarcoma: 14-year survival with multimodality therapy. Ann Thorac Surg 2004; 78: e41–2.
- 24 Yano M, Toyooka S, Tsukuda K et al. SYT-SSX fusion genes in synovial sarcoma of the thorax. Lung Cancer 2004; 44: 391–7.
- 25 Hazelbag HM, Szuhai K, Tanke HJ, Rosenberg C, Hogendoorn PC. Primary synovial sarcoma of the heart: A cytogenetic and molecular genetic analysis combining RT-PCR and COBRA-FISH of a case with a complex karyotype. Mod Pathol 2004; 17: 1434–9.
- 26 Koletsa T, Kotoula V, Hytiroglou P, Spanos P, Papadimitriou CS. Synovial sarcoma of the heart. Virchows Arch 2004; 444: 477–9.
- 27 Miller DV, Deb A, Edwards WD, Zehr KJ, Oliveira AM. Primary synovial sarcoma of the mitral valve. Cardiovasc Pathol 2005; 14: 331–3.
- 28 Provenzano SC, Con R, Jones OD, Grant PW. Synovial sarcoma of the heart. Heart Lung Circ 2006; 15: 278–9.
- 29 Zhao Q, Geha AS, Devries SR et al. Biatrial primary synovial sarcoma of the heart. J Am Soc Echocardiogr 2007; 20: 197.e1–4.
- 30 Schumann C, Kunze M, Kochs M, Hombach V, Rasche V. Pericardial synovial sarcoma mimicking pericarditis in findings of cardiac magnetic resonance imaging. Int J Cardiol 2007; 118: e83–4.
- 31 Fletcher CDM, Bruijn DRH, Kessel AG. Synovial sarcoma. In: CDM Fletcher, KK Unni, F Mertens, eds. World Health Organization Classification of Tumours. Pathology and Genetics, Tumours of Soft Tissue and Bone. Lyon: International Agency for Research on Cancer Press, 2002; 200–4.
Citing Literature
