title: Intravascular Biphasic Synovial Sarcoma: The Beneficial Role of Adjuvant Treatment Approach in the Pre-metastatic Stage.
abstract: Synovial sarcoma (SS) is a high-grade, rare variant of soft tissue sarcoma (STS). The biphasic subtype is less common than the monophasic subtype. SS is very common around joint cavities in the extremities, but can be present elsewhere in the body. Tumor staging and therapeutic management are usually clear for a localized disease, but the proper management at the metastatic stage can be unclear. According to the literature, the histologic presence of an SS tumor thrombus affects tumor staging, making it unclear whether the tumor stage corresponds to localized or metastatic disease. An intravascular SS tumor exhibiting high metastatic potential is a rare finding that warrants thorough investigation. A 49-year-old woman presented with a biphasic SS intravascular tumor of the left inguinal area with femoral vessels involvement. Ten cases of intravascular SS have been reported in the literature and contain little information regarding the proper management of a local metastatic disease. Ours is a rare case of SS with an intravascular tumor occupying the femoral-iliac vein (as seen in metastatic disease) that has been treated as a local disease with a multidisciplinary therapeutic approach. As a result, our patient has been disease-free for two years and, during that time, has achieved an acceptable quality of life. We discuss the pertinent clinical findings of this rare tumor and review the literature of tumor thrombus by SS. We also present the multidisciplinary therapeutic approach realized and the history of this disease.
authors.affiliation: Radiation Oncology, University Hospital La Fe, Valencia, Spain ; Escuela de Doctorado, Universidad Católica de Valencia "San Vicente Mártir"
authors.forename: Rodolfo
authors.initials: R
authors.lastname: Chicas-Sett
authors.affiliation: Radiation Oncology, University Hospital La Fe, Valencia, Spain.
authors.forename: Dolores
authors.initials: D
authors.lastname: Farga-Albiol
authors.affiliation: Radiation Oncology, University Hospital La Fe, Valencia, Spain.
authors.forename: Erica
authors.initials: E
authors.lastname: Collado
authors.affiliation: Radiology, University Hospital La Fe, Valencia, Spain.
authors.forename: Ariel
authors.initials: A
authors.lastname: Pacheco
authors.affiliation: Pathology, University Hospital La Fe, Valencia, Spain.
authors.forename: Carlos
authors.initials: C
authors.lastname: Zac
authors.affiliation: Oncology, University Hospital La Fe, Valencia, Spain.
authors.forename: Roberto
authors.initials: R
authors.lastname: Diaz
authors.affiliation: Radiation Oncology, University Hospital La Fe, Valencia, Spain.
authors.forename: Francisco
authors.initials: F
authors.lastname: Celada
authors.affiliation: Radiation Oncology, University Hospital La Fe, Valencia, Spain.
authors.forename: Javier
authors.initials: J
authors.lastname: Burgos
authors.affiliation: Radiation Oncology, University Hospital La Fe, Valencia, Spain.
authors.forename: Maria Jose
authors.initials: MJ
authors.lastname: Perez
authors.affiliation: Radiation Oncology, University Hospital La Fe, Valencia, Spain.
authors.forename: Alejandro
authors.initials: A
authors.lastname: Tormo
keywords: biphasic synovial sarcoma; intravascular sarcoma; radiotherapy; recurrent thrombosis; synovial sarcoma; trabectedin