Synovial sarcoma masquerading as medullary thyroid carcinoma

Yadav, Deepika; Agarwal, Shipra; Sharma, Aparna; Malik, Ekta; Kandasamy, D; Thakar, Alok; Yadav, Rajni; Barward, A; Kini, Lata

doi:10.1111/cyt.12582

Cited by 2 publications

(5 citation statements)

References 9 publications

(9 reference statements)

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“…Kikuchi et al [3] Jang et al [4] Ryu et al [5] Ghafouri et al [6] Boudin et al [7] Shi et al [8] Park et al [9] Yadav et al [10] Nicola et al [11] Present case was secondary to an extrathyroidal primary origin [12][13][14][15][16][17]. This article documents the tenth primary thyroid SS case in detail, and reviews the clinical, pathologic, and cytologic features as well as ancillary testing results of the previously reported cases (Tables 2, 3).…”

Section: Ancillary Testing Resultsmentioning

confidence: 99%

“…Although several cases of SS were reported, only 9 were well documented, by histologic and other ancillary methods, to be of thyroid origin [3][4][5][6][7][8][9][10][11]. The other reported cases did not include or illustrate histopathologic and radiologic evidence of the thyroid as the primary site, while in others the thyroid appeared normal or its involvement Table 3.…”

Section: Discussionmentioning

confidence: 99%

“…PSST, primary synovial sarcoma of the thyroid; CEA, carcinoembryonic antigen; SMA, smooth muscle actin; TTF1, thyroid transcription factor 1; CK, cytokeratin; EMA, epithelial membrane antigen. DOI: 10.1159/000507312 Clinical and pathologic features of well-documented cases of primary SSs of the thyroid in the English literature Features Kikuchi et al [3] Jang et al [4] Ryu et al [5] Ghafouri et al [6] Boudin et al [7] Shi et al [8] Park et al [9] Yadav et al [10] Nicola et al [11] Cytopathology and Histopathology Papanicolaou stained smears were highly cellular, composed of small monotonous neoplastic cells, arranged in 3D branching fragments and whorls similar to the histologic sections, which also showed 2 cell populations ( Fig. 1a-h).…”

Section: Case Presentationmentioning

confidence: 99%

“…Almost all SSs reveal a specific chromosomal change [t(X; 18) (p11.2; q11.2)], which results in the expression of a chimeric SYT-SSX gene transcript [2]. Primary SS of the thyroid (PSST) is very rare, with only 9 well-documented cases reported previously [3][4][5][6][7][8][9][10][11]. This article reports the tenth case, with extensive cytologic, histologic, immunohistochemical, and molecular findings; reviews relevant literature; and discusses the differential diagnostic issues (Tables 1-3).…”

Section: Introductionmentioning

confidence: 99%

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Primary Synovial Sarcoma of the Thyroid: Challenges in Cytologic Diagnosis and Review of the Literature

et al. 2020

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• Synovial sarcoma (SS) occurs primarily in the para-articular regions of the extremities and accounts for 5-10% of all human sarcomas. Primary involvement of the thyroid (primary SS of the thyroid), however, is very rare. • Almost all SSs reveal a specific chromosomal change [t(X; 18) (p11.2; q11.2)], which results in the expression of a chimeric SYT-SSX gene transcript. Novel Insights • Despite its bland cytologic features, PSST is a very aggressive tumor, showing a high proliferative activity with a mitotic index up to 40/10 high-power fields. • The main diagnostic pitfall of PSST is SETTLE. The presence of mitotic figures and basal lamina material in cytologic material, negative immunostaining for smooth muscle actin (SMA), and positive staining for transducer-like enhancer of split 1 (TLE-1) antibody favor SS over SETTLE. • In order to avoid potential traps in these cytologically bland neoplasms, all diagnostic clues, including molecular techniques, should be evaluated, in view of the therapeutic and prognostic implications.

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Section: Ancillary Testing Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Case Presentationmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Primary Synovial Sarcoma of the Thyroid: Challenges in Cytologic Diagnosis and Review of the Literature

et al. 2020

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“…According to different ultra structures, synovial sarcoma was divided into monophasic patterns and classic biphasic patterns (2). Synovial sarcoma in the head and neck region is relatively unusual, and primary synovial sarcoma in the thyroid gland is extremely rare with only 15 cases documented globally (3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13). Due to the rarity of the disease, challenges exist in clinical practice from diagnosis to follow-up.…”

Section: Introductionmentioning

confidence: 99%

Primary synovial sarcoma of the thyroid gland: a CARE compliant case report and literature review

Ren

Huang

et al. 2023

Front. Med.

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RationaleSynovial sarcoma is a subtype of soft tissue sarcoma. Synovial sarcoma in the head and neck region is relatively unusual. Primary synovial sarcoma of the thyroid gland (PSST) is first reported in 2003 by Inako Kikuchi. PSST is extremely rare with only 15 cases documented globally. PSST shows rapid disease progression and a relatively poor prognosis. However, diagnosis and therapy are challenging for clinical surgeons. In this article, we reported the 16th PSST case and reviewed the PSST cases globally for further clinical application.Patient concernsThe patient was referred to us because of gradually worsened dyspnea and dysphagia for 20 days. Physical examination showed a 5 × 4 cm mass with a clear boundary and good mobility. Contrast-enhanced ultrasonography (CEUS) and computed tomography (CT) showed a mass in the isthmus of the thyroid gland. The imageology diagnosis tends to be a benign thyroid nodule.DiagnosisAfter surgery, histopathology, immunohistochemistry, and fluorescence, in situ hybridization indicated the mass to be primary synovial sarcoma of the thyroid gland with no local and distant metastasis.InterventionsThe patient underwent total thyroidectomy and dissected the lymph nodes in the central compartment. This patient received postoperative chemotherapy (a combination of ifosfamide and epirubicin for five cycles). Patients tolerated chemotherapy well. No recurrence was found during the 9-month follow-up.LessonsAlthough PSST is an extremely rare disease, we should raise our awareness when we encounter a rapidly growing, cystic-solid mixed thyroid mass with neck compression symptoms to avoid misdiagnosis. Intraoperatively, surgeons should refine surgical procedures to avoid capsular rupture and tumor local implantation metastasis. Intraoperative frozen section pathology is necessary sometimes, especially when the diagnosis could not be established before surgery.

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Synovial sarcoma masquerading as medullary thyroid carcinoma

Abstract: Primary synovial sarcoma of thyroid gland is rare and rarer still is its occurrence in a patient with germline RET mutation. The cytological, histological and molecular details of one such case are presented which was thought pre‐operatively to be medullary thyroid carcinoma.

Cited by 2 publications

References 9 publications

Primary Synovial Sarcoma of the Thyroid: Challenges in Cytologic Diagnosis and Review of the Literature

Primary Synovial Sarcoma of the Thyroid: Challenges in Cytologic Diagnosis and Review of the Literature

Primary synovial sarcoma of the thyroid gland: a CARE compliant case report and literature review

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