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Poorly differentiated synovial sarcoma – a case report
Irena Ranogajec
; Department of Clinical Cytology, University Hospital for Tumors, Zagreb, Croatia
Vesna Ramljak
; Department of Clinical Cytology, University Hospital for Tumors, Zagreb, Croatia
Irena Novosel
; Department of Pathology, General Hospital «Dr Ivo Pedišić», Sisak, Croatia
Iva Bobuš-Kelčec
; Department of Clinical Cytology, University Hospital for Tumors, Zagreb, Croatia
Danko Velimir Vrdoljak
; Department of Surgical Oncology, University Hospital for Tumors, Zagreb, Croatia
Abstract
We report a rare case of primary poorly differentiated synovial sarcoma (SS) in axillary region confirmed by histology.
SS accounts for 5-10% of soft tissue sarcomas. Approximately 20% of the cases have poorly differentiated appearance, most often characterized by undifferentiated round cell morphology resembling Ewing’s sarcoma.
The differential diagnosis includes ES/PNET family of tumors, rhabdomyosarcoma, desmoid fibromatosis, and malignant melanoma.
A 46-year-old female presented to our hospital complaining of a 10 cm slightly painful mass in the right axillary region of a 2-month duration. Clinical examination (CT, ultrasound ) showed an expansive tumor mass. Cytological analysis showed the diagnosis of suspected sarcoma. Surgical treatment was performed.
Histopathological and immunohistochemical analysis confirmed the diagnosis of poorly differentiated SS.
In spite of additional methods as immunocytochemistry, the poorly differentiated variant of SS can be easily mistaken for numerous other tumors in cytological smears due to its complex, overlapping morphology and still limited experience of cytopathologists in the field of rare soft tissue tumors. Nevertheless, recognition of this variant of SS is of a major concern for its worse prognosis.
Keywords
synovial sarcoma; FNA cytology; immunocytochemistry
Hrčak ID:
281545
URI
Publication date:
30.11.2005.
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