title: Primary synovial sarcoma of the right heart involving the tricuspid valve in an elderly Chinese woman: a case report.
abstract: Described herein is a 51-year-old woman with abdominal discomfort who was found to have a pericardial effusion and a large mass in her right heart by computed tomography scan and who then underwent tumour resection surgery. The tumour was so extensive that it involved the right atrium, the right ventricle and the tricuspid valve, and encompassed the right coronary artery. The patient had no significant medical history, and no tumour was found at any other site. The morphology of the tumour mimicked carcinosarcoma, exhibiting mixed epithelioid and spindle elements and it was difficult to differentiate the diagnosis even by immunohistochemical stains. Then, the final diagnosis of primary biphasic synovial sarcoma of the heart was established based on the finding of SS18 rearrangement. This is a highly intriguing rare case that may represent a diagnostic pitfall, particularly regarding frozen section. The patient will receive chemotherapy, and we will pursue follow-up.
authors.affiliation: Department of Pathology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, No.1Shuaifuyuan, Wangfujing Street, Dongcheng District, Beijing, 100730, China. huozhen1976@126.com.
authors.forename: Zhen
authors.initials: Z
authors.lastname: Huo
authors.affiliation: Department of Pathology, Cancer Hospital/Institute, Chinese Academy of Medical Sciences, Beijing, 100021, China. haizhen.lu@gmail.com.
authors.forename: Haizhen
authors.initials: H
authors.lastname: Lu
authors.affiliation: Department of Cardiac Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100730, China. miaoqipumc@hotmail.com.
authors.forename: Qi
authors.initials: Q
authors.lastname: Mao
authors.affiliation: Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100730, China. zhengyu_jin@126.com.
authors.forename: Zhengyu
authors.initials: Z
authors.lastname: Jin
authors.affiliation: Department of Pathology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, No.1Shuaifuyuan, Wangfujing Street, Dongcheng District, Beijing, 100730, China. whw14093@163.com.
authors.forename: Huanwen
authors.initials: H
authors.lastname: Wu
authors.affiliation: Department of Pathology, Cancer Hospital/Institute, Chinese Academy of Medical Sciences, Beijing, 100021, China. fengxl@hotmail.com.
authors.forename: Xiaoli
authors.initials: X
authors.lastname: Feng
authors.affiliation: Department of Pathology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, No.1Shuaifuyuan, Wangfujing Street, Dongcheng District, Beijing, 100730, China. iu7512@163.com.
authors.forename: Yu
authors.initials: Y
authors.lastname: Xiao
authors.affiliation: Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100730, China. yininpumc@hotmail.com.
authors.forename: Yining
authors.initials: Y
authors.lastname: Wang
authors.affiliation: Department of Pathology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, No.1Shuaifuyuan, Wangfujing Street, Dongcheng District, Beijing, 100730, China. Guolnmm@sina.com.
authors.forename: Lina
authors.initials: L
authors.lastname: Guo
mesh_terms: D014408:Biomarkers, Tumor / Q000032:analysis / Q000235:genetics; D017024:Chemotherapy, Adjuvant; D002681:China; D003937:Diagnosis, Differential; D005260:Female; D005629:Frozen Sections; D015321:Gene Rearrangement; D006338:Heart Neoplasms / Q000737:chemistry / Q000150:complications / Q000235:genetics / Q000473:pathology* / Q000601:surgery; D006801:Humans; D007150:Immunohistochemistry; D017404:In Situ Hybridization, Fluorescence; D008875:Middle Aged; D016612:Paraffin Embedding; D010490:Pericardial Effusion / Q000209:etiology; D011237:Predictive Value of Tests; D011518:Proto-Oncogene Proteins / Q000235:genetics; D012097:Repressor Proteins / Q000235:genetics; D013584:Sarcoma, Synovial / Q000737:chemistry / Q000150:complications / Q000235:genetics / Q000473:pathology* / Q000601:surgery; D014057:Tomography, X-Ray Computed; D014261:Tricuspid Valve / Q000737:chemistry / Q000473:pathology* / Q000601:surgery
chemical_list: D014408:Biomarkers, Tumor; D011518:Proto-Oncogene Proteins; D012097:Repressor Proteins; C093961:SS18 protein, human