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He J, Wang J, Yang L, Wang K, Wang M, Li J. Synovial sarcoma of the viscera (lung and jejunum): a case report. J Int Med Res 2024; 52:3000605241233953. [PMID: 38534077 PMCID: PMC10981226 DOI: 10.1177/03000605241233953] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Accepted: 01/29/2024] [Indexed: 03/28/2024] Open
Abstract
We report the case of a woman nearing 70 years old who was admitted to the hospital with a complaint of "epigastric distension for 1 month". Her main signs and symptoms were progressive abdominal distension and occasional abdominal pain. Computed tomography suggested an abdominal mass. She had a surgical history of synovial sarcoma (SS) of the lungs. After admission, she was diagnosed with jejunal SS following a puncture biopsy and laparoscopic surgery. This disease usually occurs in the soft tissues of the limbs, and it is extremely rare for SS to originate in the jejunum. The morphologic heterogeneity of SS overlaps with other tumors and makes the diagnosis particularly difficult. Imaging studies usually lack specificity; however, measuring multiple immunohistochemical markers can greatly assist in the diagnosis and differential diagnosis of SS. This case not only enriches our understanding of SS and describes a rare site of origin, but also emphasizes the importance and challenges of achieving an accurate diagnosis. Immunohistochemical and molecular biological testing have important roles in the definitive diagnosis, highlighting the need for precise and innovative diagnostic and therapeutic approaches in SS.
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Affiliation(s)
- Jixin He
- Department of General Surgery, Digestive Disease Hospital, Affiliated Hospital of Zunyi Medical University, Zunyi City, Guizhou Province, China
| | - Jiwei Wang
- Department of General Surgery, Digestive Disease Hospital, Affiliated Hospital of Zunyi Medical University, Zunyi City, Guizhou Province, China
| | - Lina Yang
- Operation Room of the Affiliated Hospital of Zunyi Medical University, Zunyi City, Guizhou Province, China
| | - Kai Wang
- Department of Pathology, Affiliated Hospital of Zunyi Medical University, Zunyi City, Guizhou Province, China
| | - Maijian Wang
- Department of General Surgery, Digestive Disease Hospital, Affiliated Hospital of Zunyi Medical University, Zunyi City, Guizhou Province, China
| | - Jianguo Li
- Department of General Surgery, Digestive Disease Hospital, Affiliated Hospital of Zunyi Medical University, Zunyi City, Guizhou Province, China
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Machado I, Martí Ibor E, Berbegall AP, Alcácer Fernández-Coronado J, Claramunt R, Duarte Novo JE, Mosquera Reboredo J, Concha López Á, Alcácer García J. [Histological, immunohistochemical and molecular study of a paratesticular dedifferentiated liposarcoma with inflammatory myofibroblastic tumor-like features]. REVISTA ESPANOLA DE PATOLOGIA : PUBLICACION OFICIAL DE LA SOCIEDAD ESPANOLA DE ANATOMIA PATOLOGICA Y DE LA SOCIEDAD ESPANOLA DE CITOLOGIA 2022; 55:212-217. [PMID: 35779890 DOI: 10.1016/j.patol.2021.07.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/18/2021] [Revised: 06/26/2021] [Accepted: 07/04/2021] [Indexed: 06/15/2023]
Abstract
We report the histological, immunohistochemical, and molecular findings of a dedifferentiated liposarcoma with inflammatory myofibroblastic tumor-like features occurring in the paratesticular region. Histologically, the dedifferentiated component closely resembled an inflammatory myofibroblastic tumor. The neoplastic cells were positive for smooth muscle actin with focal CD56, CD99, Bcl2 and EMA expression. WT1, calretinin, myogenin, CK(AE1/AE3), desmin, H-caldesmon, CD34, ALK, CKIT, DOG1, MUC4 and STAT6 were negative. MDM2 showed diffuse and strong nuclear positivity in neoplastic cells and fluorescence in situ hybridization (FISH) revealed amplified MDM2 (high level) but no SYT rearrangement. Although a lipomatous component was evident macroscopically, well-differentiated liposarcomatous components were not evident in the section examined. Dedifferentiated liposarcoma can have prominent inflammatory myofibroblastic tumor-like features. Pathologists should be aware of this histological variant in order to avoid misdiagnosing dedifferentiated liposarcoma as inflammatory myofibroblastic tumor or other spindle cell tumors which have different behavioral patterns and treatment requirements.
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Affiliation(s)
- Isidro Machado
- Departamento de Patología, Instituto Valenciano de Oncología, Valencia, España; Departamento de Patología, Patologika Laboratorio, Hospital Quirón-Salud, Valencia, España.
| | - Encarnación Martí Ibor
- Departamento de Patología, Patologika Laboratorio, Hospital Quirón-Salud, Valencia, España; Departamento de Patología, Hospital Peset Alexandre, Valencia, España
| | - Ana P Berbegall
- Departamento de Patología, Patologika Laboratorio, Hospital Quirón-Salud, Valencia, España
| | | | - Reyes Claramunt
- Departamento de Biología Molecular, Instituto Valenciano de Oncología, Valencia, España
| | | | | | | | - Javier Alcácer García
- Departamento de Patología, Patologika Laboratorio, Hospital Quirón-Salud, Valencia, España
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Pors J, Devereaux K, Hildebrandt D, Longacre TA. Primary Uterine Synovial Sarcoma with SMARCA4 Loss: A Case Report. Histopathology 2022; 80:1135-1137. [PMID: 35233814 DOI: 10.1111/his.14636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Revised: 02/26/2022] [Accepted: 02/28/2022] [Indexed: 11/27/2022]
Affiliation(s)
- Jennifer Pors
- Department of Pathology, Stanford University School of Medicine, Stanford, CA, 94305, Canada.,Department of Pathology, BC Cancer Agency, Vancouver, BC, V5Z 4E6, Canada
| | - Kelly Devereaux
- Department of Pathology, Stanford University School of Medicine, Stanford, CA, 94305, Canada
| | - Daniella Hildebrandt
- Department of Pathology, Stanford University School of Medicine, Stanford, CA, 94305, Canada
| | - Teri A Longacre
- Department of Pathology, Stanford University School of Medicine, Stanford, CA, 94305, Canada
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Stocker M, Le Nail LR, De Belenet H, Wunder JS, Andrulis IL, Gokgoz N, Levy N, Mattei JC, Olschwang S. Inhibition of P53-mediated cell cycle control as the determinant in dedifferentiated liposarcomas development. Am J Cancer Res 2021; 11:3271-3284. [PMID: 34249461 PMCID: PMC8263664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Accepted: 04/28/2021] [Indexed: 06/13/2023] Open
Abstract
Liposarcomas are a heterogeneous group of sarcomas, including well-differentiated and dedifferentiated liposarcoma, myxoid/round cell liposarcoma, and pleomorphic liposarcoma. Complete surgical resection is the key of treatment. Radiotherapy, based on the tumor grade and the vicinity of critical structures with the tumor, can be used to prevent local recurrence. The group of dedifferentiated liposarcomas (DDLS) is poorly sensitive to adjuvant chemotherapy. Improved understanding of the genetic aberrations that lead to liposarcoma initiation is necessary for the development of targeted therapies to improve tumor control and survival. DDLS share genetic abnormalities with other groups, exhibiting high-level amplifications of chromosome 12, including the MDM2 and CDK4 genes, and harbor additional amplifications of chromosomes 6 and 1. Novel therapies targeted at the gene products of chromosome 12 are currently considered in clinical trials. Our work consisted in a genomic characterization of DDLS to draw up a complete picture of alterations, including genomic signatures, tumor mutation burden, gene mutations, copy number variations, translocations, gene fusions and methylation modifications. Analysis of translocations helped to understand the mechanisms underlying the amplification processes. Combination of mutations and loss of heterozygosity or homozygous deletions were detected and led to inactivate tumor suppressor genes (TSG). In contrast, methylation anomalies seemed not linked to any particular genomic profile. All identified anomalies, whether amplifications and/or TSG inactivation, involve genes playing a role in p53 regulation, that appears to be the epicenter of the initiation process in DDLS tumorigenesis, as is also known to be responsible for Li-Fraumeni syndrome, a family cancer syndrome highly predisposing to sarcomas.
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Affiliation(s)
- Mossane Stocker
- INSERM UMR1251 Marseille Medical Genetics GeneticsMarseille, France
- GCS Pour l’Enseignement et la Recherche, Ramsay Santé, Hôpital Privé ClairvalMarseille, France
| | | | - Hubert De Belenet
- GCS Pour l’Enseignement et la Recherche, Ramsay Santé, Hôpital Privé ClairvalMarseille, France
| | - Jay S Wunder
- Lunenfeld_Tanenbaum Research Institute, University of TorontoToronto, Canada
| | - Irene L Andrulis
- Lunenfeld_Tanenbaum Research Institute, University of TorontoToronto, Canada
| | - Nalan Gokgoz
- Lunenfeld_Tanenbaum Research Institute, University of TorontoToronto, Canada
| | - Nicolas Levy
- INSERM UMR1251 Marseille Medical Genetics GeneticsMarseille, France
- AP-HMMarseille, France
| | - Jean-Camille Mattei
- INSERM UMR1251 Marseille Medical Genetics GeneticsMarseille, France
- AP-HMMarseille, France
| | - Sylviane Olschwang
- INSERM UMR1251 Marseille Medical Genetics GeneticsMarseille, France
- GCS Pour l’Enseignement et la Recherche, Ramsay Santé, Hôpital Privé ClairvalMarseille, France
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