Synovial sarcoma of the buttocks presenting with a non-healing wound and rapid progression after local resection: a case report

Zhang, Haiyan; Feng, Yang; Zhang, Zhuo; Gao, Ge; Zhao, Jingbo

doi:10.1186/1477-7819-10-125

Cited by 6 publications

(5 citation statements)

References 15 publications

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“…The rarity of this disease can lead to a lack of consideration of STS in the differential diagnosis of a soft tissue mass in the buttock area, that can mimic an hematoma or a non-healing wound [12][13][14]. Surgical resection without preoperative staging and consideration of the need to remove a normal tissue envelope around the tumor, namely unplanned excision or whoops surgeries, is inadequate for the treatment of STS even in combination with radiation therapy or chemotherapy, and requires surgical revision.…”

Section: Discussionmentioning

confidence: 99%

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High-grade soft tissue sarcomas of the buttock: a case series and surgical technique

Sacco

Piana

Pellegrino

et al. 2023

Preprint

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Objective Soft tissue sarcomas of the buttock (BSTS) are historically associated with a poor prognosis. The literature concerning BSTS includes outdated single-center retrospective case series, and case reports. We aimed to analyze the oncologic outcomes of high-grade BSTS according to current treatment modalities, and to present a detailed surgical technique of buttectomy,. Methods Consecutive patients diagnosed with BSTS from 2016 to 2021, were retrospectively evaluated for the rate of local control, distant metastases, overall survival (OS) and disease-free survival (DFS). Inclusion criteria: (1) high-grade STS confirmed by pathological biopsy, (2) tumors localized to the buttock, (3) surgical treatment, (4) age > 18 years. All patients underwent surgical resection. Chemotherapy and/or radiation therapy was administered according to a standardized protocol. Functional outcome was assessed with the Musculoskeletal Tumor Society score (MSTS 1993). Results Nine high-grade, G2/3 BSTS were included; mean age 60.1 years (range, 30–86), and mean follow-up 4,5 years (range, 1–7). There were 7 undifferentiated pleomorphic sarcoma, 1 fibrosarcoma, and 1 myxoid liposarcoma. Three patients were referred after whoops surgeries, 33% (3/9). Overall, the deep gluteal space was invaded in three out of nine patients, and the subcutaneous fat in another three out of nine patients; wide margins were achieved only in two patients. At the last follow-up, two patients developed distant metastasis and died, in one case with invasion of the deep gluteal space, and in another of the subcutaneous fat; 7/9 patients were alive and disease-free. The LR rate was 33% (2/6), the 5-year OS and DFS were 66% (5/7). The MSTS 1987 scores averaged 89.0 (range 76–100). Conclusion BSTS are still associated with high rates of whoops surgeries and local recurrence in agreement with previous evidence from 1948 to 2002. Buttectomy for high-grade BSTS provided acceptable oncological outcomes when performed by a trained team using a precise surgical technique, in association to a multimodal therapy.

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Section: Discussionmentioning

confidence: 99%

“…buttectomy) and radiation therapy, while the role of chemotherapy is still unclear [5]. To date, the literature concerning BSTS includes single-center retrospective case series [4,[6][7][8][9][10], and case reports [11][12][13][14][15]. Therefore, there is a lack of studies that have adopted contemporary oncological treatment guidelines.…”

Section: Introductionmentioning

confidence: 99%

High-grade soft tissue sarcomas of the buttock: a case series and surgical technique

Sacco

Piana

Pellegrino

et al. 2023

Preprint

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“…This diagnostic difficulty comes from this exceptional anatomical location, only less than 10 isolated case reports with intergluteal location are published in the literature 4 and from the confusion with other benign or malignant tumors of intergluteal location 11 .…”

Section: Discussionmentioning

confidence: 99%

“…We report, according to the Surgical CAse REport (SCARE) recommendations, an exceptional localization of synovial sarcoma in the buttocks, making one case among less than 10 cases published through the literature with a total annual incidence of all synovial sarcoma estimated at 1/1 000 000 4 …”

Section: Introductionmentioning

confidence: 99%

Synovial sarcoma in the buttocks: an exceptional location – case report according to SCARE guidelines

Elmir

Arghal²,

Malki

et al. 2023

Annals of Medicine &Amp; Surgery

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Introduction and Importance: Pelvic pain is a frequent reason for consultation; the management is complex, given the differences in symptomatic and anatomical orientation. We present an exceptional case of intergluteal synovial sarcoma rarely described in the literature, with an incidence of about 1/1 000 000 and less than 10 cases of intergluteal location are published. Case Presentation: Through this publication, we present a very exceptional case of synovial sarcoma. It concerns a 44-year-old male followed for probable intergluteal lipoma for 3 months and admitted for intergluteal mass bleeding. The clinical examination revealed an intergluteal tumor mass, and the surgical resection was in favor of a synovial sarcoma. The objectives of this work are threefold: to enrich the poor literature with this new case; to underline the importance of multidisciplinary management; to recommend the obligation of anatomopathological evidence to make the diagnosis of lipoma in front of a soft tissue tumor. Discussion and Conclusion: Our case enriches the poor literature on intergluteal synovial sarcoma, where less than 10 similar reports are available. We hope through our presentation to highlight this exceptional etiology of gluteal tumor and to recall that there is no relationship between the name of this tumor and the synovium as an anatomical entity.

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“…The biphasic subtype shows co-existence of epithelioid cells and spindle cells. However, the monophasic subtype is entirely composed of spindle cells; in this case, immunonegativity for CD34 is helpful to exclude the diagnosis [ 11 ].…”

Section: Discussionmentioning

confidence: 99%

Malignant Solitary Fibrous Tumor with Heterologous Rhabdomyosarcomatous Differentiation: A Case Report

Kwon

Song

Jung

et al. 2017

J Pathol Transl Med

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Malignant solitary fibrous tumor (MSFT) is a well-described entity, from which heterologous differentiation is extremely rare. We encountered a case of MSFT with rhabdomyosarcomatous differentiation in a 56-year-old man. This patient presented with a large mass in his posterior thigh. He had been treated with chemoradiation for sarcoma involving the cervical spine, right femoral head, and both lungs 6 months earlier. A wide excision was performed. The mass measured 10.6 cm and showed a fish-flesh cut surface with necrotic foci. Microscopically, the tumor showed heterogeneous cellularity with a hemangiopericytic vascular pattern. A hypercellular area showed spindle cells or epithelioid cells with high mitotic activity (63/10 high-power fields) and immunoreactivity for CD34 and CD99. A hypocellular area and a cystic area showed pleomorphic rhabdoid cells with immunoreactivity for desmin and myogenin. This is a report of a rare case of MSFT with rhabdomyosarcomatous differentiation and presents new histologic features of MSFT.

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Synovial sarcoma of the buttocks presenting with a non-healing wound and rapid progression after local resection: a case report

Cited by 6 publications

References 15 publications

High-grade soft tissue sarcomas of the buttock: a case series and surgical technique

High-grade soft tissue sarcomas of the buttock: a case series and surgical technique

Synovial sarcoma in the buttocks: an exceptional location – case report according to SCARE guidelines

Malignant Solitary Fibrous Tumor with Heterologous Rhabdomyosarcomatous Differentiation: A Case Report

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