Synovial sarcoma: A clinicopathological study of 36 cases

Abstract

Thirty-six cases of synovial sarcoma (13 biphasic and 23 monophasic) were subjected to a clinicopathologic study that included electron microscopy and immunohistochemistry. The group consisted of 21 males and 15 females ranging in age from 2 to 63 years. The majority of tumors (27 cases) were found in the hip and lower extremity. Immunohistochemical study revealed that keratin, which was detected in 92% of the biphasic and 57% of the monophasic tumors, was a more sensitive marker of epithelial differentiation than EMA or CEA. The overall 5-year survival of the patients was 64%. Male sex, older age, presence of tumor necrosis, monophasic pattern, and absence of keratin positivity had an unfavourable effect on survival but lacked statistical significance. Survival was significantly lower in patients with tumors exhibiting more than 15 mitoses per 10 HPF (P less than .02) and in those with tumors showing necrosis and a mitotic rate greater than 5 mitoses per 10 HPF (P less than .005).

Primary Retroperitoneal Synovial Sarcoma.

“…Generally, the 5-year survival rate for patients with synovial sarcoma is 20-29% (12,18). Those with tumors that show a mitotic ratio higher than 15 per 10 HPF have the poorest prognosis (25). Only one ( 12.5%) of the cases ofretroperitoneal synovial sarcoma survived five years after resection (Table 2).…”

Synovial sarcoma

“…Enzinger and Weiss (1995) has reported a male to female ratio of 1.2:1. Since this series can be regarded as population based the true median age of synovial sarcoma patients at diagnosis is most likely higher and the median tumor size smaller than earlier reported (Mullen et al 1994, Cameron et al 1974, Chong et al 1995, Singer et al 1996Wright et al 1985, Golouh et al 1990). Synovial sarcoma seems to be rare in early childhood.…”

Cervical Nerve Root Synovial Sarcoma in a Child with Chromosomal (X;18) Translocation

“…Local recurrence was reported in 14–35% of cases [15, 19, 20]. Most authors agree that small tumor size, absence of invasiveness [10, 11, 15, 20, 21], poorly differentiated variants [21], a low mitotic index [11, 12], absence of tumor necrosis [11, 12, 21] and a surgical removal with negative resection margin [11, 20] are significant positive prognostic factors. The fact that age or gender of the patient as well as location of the tumor might have an influence on the prognosis is controversial [12, 20, 21].…”

“…This tumor is slightly predominant in males with a sex ratio of 1.5M/1F [5, 12]. Several ultrastructural [13] and immunohistochemical [14] studies have failed to demonstrate a synovial origin for this tumor, and the current consensus is that it derives from pluripotential mesenchymal cells [2] close or remote from the articular surface.…”