Retroperitoneal synovial sarcoma: a clinicopathological study of 6 cases.
OBJECTIVE
Synovial sarcoma (SS) arising in the retroperitoneum is a rare tumor. In this location it can be confused with other biphasic tumors and with other spindle and round cell sarcomas. We report 6 cases of SSs with emphasis on their clinicopathological findings.


METHODS
Six cases were studied, diagnosed as primary retroperitoneal SSs. Clinical, radiological and pathological findings were included in the study. Follow-up information was available in 5 out of 6 cases.


RESULTS
The cases consisted of 5 males and 1 female (aged 27-42 years, median 34), who complained preoperatively for pain in the abdominal region (n=4) and dysuria (n=2). Clinical examination was negative. Abdominal X-ray showed a suspicious mass in 4 cases and computed tomography (CT) revealed the tumor mass in all cases. Surgical removal of the tumor was performed. Tumors ranged in size from 6.5 to 14 cm (median 11); histologically, all tumors were biphasic and 1 had poorly differentiated areas. Sarcomas were of high grade (n=3) and intermediate grade of malignancy (n=3). Immunohistochemical stains for cytokeratins AE1/AE3, CAM5.2, S-100, CD34, EMA, SMA and CD99 were performed. All tumors recurred or metastasized within the abdomen. Four patients died of disease within 8-38 months.


CONCLUSIONS
Retroperitoneal SSs are very rare neoplasms that attain a large size, are difficult to excise and recur locally. Metastatic potential is low; however, mortality is very high.
Department of Pathology, Hippokration General Hospital of Athens, 6-8 Stasinou Street, Athens, Greece. pchatzipantelis@yahoo.com
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Chatzipantelis
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Kafiri
D000328:Adult; D000368:Aged; D014408:Biomarkers, Tumor / Q000378:metabolism*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007124:Immunoenzyme Techniques; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012186:Retroperitoneal Neoplasms / Q000378:metabolism / Q000556:secondary*; D013584:Sarcoma, Synovial / Q000378:metabolism / Q000473:pathology*; D015996:Survival Rate
D014408:Biomarkers, Tumor