Three cases of synovial sarcoma of gastric wall: A case report and review of the literature

Kuboyama, Yusuke; Yamada, Yuichi; Kohashi, Kenichi; Toda, Yu; Kawakami, Koji; Kitahara, Daichi; Nishiyama, Kenichi; Hiraki, Yuka; Oya, Masafumi; Oda, Yoshinao

doi:10.1016/j.prp.2021.153352

Cited by 4 publications

(4 citation statements)

References 23 publications

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“…Tumors were often locally located in the body and fundus of the stomach, with a median size of 5.46 cm; many also had ulcers. Recently, reports of this tumor type have been increasing [24,[27][28][29][30], which may be a result of improved understanding of this tumor type and advances in diagnostic ability.…”

Section: Discussionmentioning

confidence: 99%

“…A total of 44 cases of primary gastric synovial sarcoma have been reported thus far, and surgical procedures conducted were as follows: tumorectomy in five cases, wedge resection in nine cases, partial gastrectomy in seven cases, gastrectomy in four cases, distal gastrectomy in two cases, total gastrectomy in three cases, antrectomy in one case, intragastric resection in one case, and surgical resection in two cases. No data were available in ten cases [24,[26][27][28][29][30]. Thus, LECS procedure has not been reported.…”

Section: Discussionmentioning

confidence: 99%

“…Recently, reports of this tumor type have been increasing [ 24 , 27 – 30 ], which may be a result of improved understanding of this tumor type and advances in diagnostic ability.…”

Section: Discussionmentioning

confidence: 99%

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Primary gastric synovial sarcoma resected by laparoscopic endoscopic cooperative surgery of the stomach: a case report

et al. 2021

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Background Primary gastric synovial sarcoma is extremely rare, only 44 cases have been reported so far, and there have been no reports of laparoscopic endoscopic cooperative surgery for this condition. Case presentation A 45-year-old male patient presented with gastric pain. Esophagogastroduodenoscopy was performed that led to the identification of an 8-mm submucosal tumor in the anterior wall of the antrum, and a kit-negative gastrointestinal stromal tumor was suspected following biopsy. On endoscopic ultrasonography, the boundary of the tumor, mainly composed of the second layer, was depicted as a slightly unclear low-echo region, and a pointless no echo region was scattered inside. A boring biopsy revealed synovial sarcoma. Positron emission tomography did not reveal fluorodeoxyglucose (18F-FDG) accumulation in the stomach or other organs. Thus, the patient was diagnosed with a primary gastric synovial sarcoma, and laparoscopic endoscopic cooperative surgery was performed. The tumor of the antrum could not be confirmed laparoscopically from the serosa, and under intraoperative endoscopy, it had delle on the mucosal surface, which was removed by a method that does not involve releasing the gastric wall. Immunohistochemistry showed that the spindle cells were positive for EMA, BCL-2 protein, TLE-1, and SS18-SSX fusion-specific antibodies but negative for KIT and DOG-1. The final pathological diagnosis was synovial sarcoma of the stomach. The postoperative course was good, and the patient was discharged from the hospital on the 11th postoperative day. Conclusion Resection with laparoscopic endoscopic cooperative surgery (LECS), which has not been reported before, was effective for small synovial sarcomas that could not be confirmed laparoscopically. With the combination of laparoscopic and endoscopic approaches to neoplasia with a non-exposure technique (CLEAN-NET) procedure, it was possible to excise the tumor with the minimum excision range of the gastric serosa without opening the stomach.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Primary gastric synovial sarcoma resected by laparoscopic endoscopic cooperative surgery of the stomach: a case report

et al. 2021

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“…When enlarged, other subepithelial tumors show the same central ulceration, but when small tumors are accompanied by ulceration, the possibility of synovial sarcoma should be kept in mind. The smallest case previously reported was 8 mm in diameter [ 6 ], and five cases were in the 10 mm range [ 6 , 15 , 22 , 25 ]. All of them underwent wedge resection or partial resection, and none of the described cases were treated with additional therapy, and no recurrence was reported.…”

Section: Discussionmentioning

confidence: 99%

A minute primary gastric synovial sarcoma with ulcer: a case report

et al. 2021

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Background Synovial sarcomas are a rare type of high-grade sarcomas with unknown cell origin. They arise predominantly in the soft tissues but rarely in the stomach. We recently encountered a rare case of minute gastric synovial sarcoma. Case presentation A 61-year-old Japanese woman was pointed out edematous erosion at the body of the stomach. Biopsy specimen showed dense proliferation of spindle-shaped tumor cells mixed with smooth muscle fibers of the muscularis mucosae. Although the definite histological diagnosis was undetermined, the patient underwent laparoscopic wedge resection of the stomach. Histological examination of the resected sample revealed that the maximum diameter of the tumor was only 6 mm and that dense proliferation of rather uniform spindle tumor cells were observed mainly in the submucosa. Immunohistochemistry showed that they were positive for pan-keratin, CD99 and TLE1. SS18-SSX fusion-specific antibody gave diffuse positive staining to the tumor cells, and analysis using mRNA extracted from paraffin sections revealed that the tumor had SS18-SSX1 fusion gene. Thus, it was diagnosed as gastric synovial sarcoma, monophasic fibrous type. Conclusions Primary synovial sarcoma of the stomach is rare and only 47 cases have been reported in the English literature to date. The maximum diameter of the lesion of our case was 6 mm which is the smallest among them.

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Mesenchymal tumors of the stomach: radiologic and pathologic correlation

Madhusudhan

Das

2022

Abdom Radiol

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Three cases of synovial sarcoma of gastric wall: A case report and review of the literature

Cited by 4 publications

References 23 publications

Primary gastric synovial sarcoma resected by laparoscopic endoscopic cooperative surgery of the stomach: a case report

Primary gastric synovial sarcoma resected by laparoscopic endoscopic cooperative surgery of the stomach: a case report

A minute primary gastric synovial sarcoma with ulcer: a case report

Mesenchymal tumors of the stomach: radiologic and pathologic correlation

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