title: Primary Intracranial Synovial Sarcoma.
abstract: Background. Synovial sarcoma is an aggressive soft tissue sarcoma with uncertain histological origin. The pathology frequently presents as a localized disease, especially near large joints around the knee and thigh. Intracranial disease, which is rare, has been reported as metastasis from synovial sarcoma. We report a case with no obvious primary extracranial pathology, suggesting primary intracranial disease; this has not been reported in the literature. Case Description. A 21-year-old male, with a prior right skull lesion resection for atypical spindle cell neoplasm, presented with headaches, gait instability, left arm weakness, and left homonymous hemianopsia. CT of head demonstrated a right parietal hemorrhagic lesion with mass effect, requiring surgical decompression. Histopathology revealed synovial sarcoma. FISH analysis noted the existence of the t(X;18)(p11.2;q11.2) chromosomal translocation. PET scan did not show other metastatic disease. He underwent stereotactic radiotherapy and adjuvant chemotherapy. At 2-year follow-up, he remained nonfocal without recurrence. Conclusion. We report the first known case of primary intracranial synovial sarcoma. Moreover, we stress that intracranial lesions may have a tendency for hemorrhage, requiring urgent lifesaving decompression.
authors.affiliation: Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, WI 53226, USA.
authors.forename: Mohit
authors.identifier: 0000-0003-0412-7247
authors.initials: M
authors.lastname: Patel
authors.affiliation: Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, WI 53226, USA.
authors.forename: Luyuan
authors.initials: L
authors.lastname: Li
authors.affiliation: Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, WI 53226, USA.
authors.forename: Ha Son
authors.identifier: 0000-0002-3515-278X
authors.initials: HS
authors.lastname: Nguyen
authors.affiliation: Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, WI 53226, USA.
authors.forename: Ninh
authors.identifier: 0000-0003-0467-3440
authors.initials: N
authors.lastname: Doan
authors.affiliation: Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, WI 53226, USA.
authors.forename: Grant
authors.initials: G
authors.lastname: Sinson
authors.affiliation: Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, WI 53226, USA.
authors.forename: Wade
authors.initials: W
authors.lastname: Mueller