A primary gastric synovial sarcoma: A case report and literature review. Issue 49 (December 2017)

• Record Type: Journal Article
• Authors: So, In Tae; Cho, Kwang Bum; Lee, Ju Yup; Kim, Sang Jin; Jung, Hye In; Choi, Jong Hwan; Lee, Yoo Jin; Lee, Hyun Jik; Park, Kyung Sik; Ryu, Seung Wan; Kang, Yu Na
• Other Names: NA. section editor.
• Is Part Of: Medicine. Volume 96:Issue 49(2017)
• Publication Date: 2017-12
• Subjects: endoscopy -- gastric neoplasm -- synovial sarcoma; Medicine -- Periodicals; Medicine -- Periodicals; Médecine -- Périodiques; Geneeskunde; Medicine; Periodicals; Periodicals; 610.5
• DOI: 10.1097/MD.0000000000008904
• Languages: English
• ISSNs: 0025-7974

Abstract

Abstract: Rationale: When a gastric spindle cell tumor is observed, the possibility of synovial carcinoma, besides common mesenchymal tumor, should also be considered. Presenting concerns of the patient: The patient is a 51-year-old American woman who underwent medical check-up at a general hospital. Upper endoscopy showed a 2-cm sized mass covered with intact mucosa, and a central depression located on the posterior wall of the mid body. Biopsy of the mass showed focal atypical cells proliferation in mucosa on hematoxylin & eosin (H&E) staining. Endoscopic ultrasound showed a 17-mm homogenously hypoechoic mass within the submucosal layer. Interventions: After diagnostic endoscopic submucosal dissection was performed, H&E and immunohistochemical staining showed synovial sarcoma (SS). To confirm the diagnosis, reverse transcriptase-polymerase chain reaction was performed, revealing a chimeric transcript of the SYT-SSX1 fusion gene. The diagnosis of primary gastric SS was confirmed because no evidence of possible primary lesions or metastatic lesions was observed. Therefore, the patient underwent distal gastrectomy. Outcomes: After surgery, the surgical specimen demonstrated no residual tumor cells. The patient received no adjuvant therapy, and there has been no evidence of local recurrence or distant metastasis for 2 months after the operation. Lessons: When gastric subepithelial tumor is suspicious, we should also consider gastric SS.