Synovial Sarcoma of the Nerve—Clinical and Pathological Features: Case Series and Systematic Review. Issue 6 (21st August 2019)

• Record Type: Journal Article
• Authors: Burks, Stephen Shelby; Puffer, Ross C; Cajigas, Iahn; Valdivia, David; Rosenberg, Andrew E; Spinner, Robert J; Levi, Allan D
• Is Part Of: Neurosurgery. Volume 85:Issue 6(2019)
• Page Start: E975
• Page End: E991
• Publication Date: 2019-08-21
• Subjects: Synovial sarcoma -- Peripheral nerve -- Plexus -- Intraneural -- SSPN; Nervous system -- Surgery -- Periodicals; 617.48005
• DOI: 10.1093/neuros/nyz321
• Languages: English
• ISSNs: 0148-396X

Abstract

Abstract: BACKGROUND: Synovial sarcoma of the nerve is a rare entity with several cases and case series reported in the literature. Despite an improved understanding of the biology, the clinical course is difficult to predict. OBJECTIVE: To compile a series of patients with synovial sarcoma of the peripheral nerve (SSPN) and assess clinical and pathological factors and their contribution to survival and recurrence. METHODS: Cases from 2 institutions collected in patients undergoing surgical intervention for SSPN. Systematic review including PubMed and Scopus databases were searched for related articles published from 1970 to December 2018. Eligibility criteria: (1) case reports or case series reporting on SSPN, (2) clinical course and/or pathological features of the tumor reported, and (3) articles published in English. RESULTS: From patients treated at our institutions (13) the average follow-up period was 3.2 yr. Tumor recurrence was seen in 4 cases and death in 3. Systematic review of the literature yielded 44 additional cases with an average follow-up period of 3.6 yr. From pooled data, there were 10 recurrences and 7 deaths (20% and 14%, respectively). Adjuvant treatment used in 62.5% of cases. Immunohistochemical markers used in diagnosis varied widely; the most common are the following: Epithelial membrane antigen (EMA), cytokeratin, vimentin, cluster of differentiation (CD34), and transducin-like enhancer of split 1 (TLE1). Statistical analysis illustrated tumor size and use of chemotherapy to be negative predictors of survival. No other factors, clinically or from pathologist review, were correlated with recurrence or survival. CONCLUSION: By combining cases from our institution with historical data and performing statistical analysis we show correlation between tumor size and death.