A case report of pancreatic metastasis from synovial sarcoma successfully treated by metastasectomy with adjuvant chemotherapy

Yuki Makino, Minoru Shigekawa, Tadashi Kegasawa, Takahiro Suda, Teppei Yoshioka, Kiyoshi Iwahashi, Kenji Ikezawa, Ryotaro Sakamori, Takayuki Yakushijin, Jun Kajihara, Yoshito Tomimaru, Hidetoshi Eguchi, Yoshinori Imura, Hidetatsu Outani, Norifumi Naka, Keiichiro Honma, Eiichi Morii, Tomohide Tatsumi, Naoki Hiramatsu, Tetsuo Takehara

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Abstract

Introduction: Synovial sarcoma is a malignant soft tissue sarcoma which arises near joints. The most frequent metastasis sites of synovial sarcoma are the lungs, lymph nodes, and bone. Pancreatic metastasis is quite rare; only 3 cases have been reported worldwide to date. We herein present the 4th case of pancreatic metastasis from synovial sarcoma. Methodsand Results: A 32-year-old man underwent extended excision of synovial sarcoma in the left pelvis and femur in 2009. In 2013, follow-up contrast-enhanced computed tomography revealed a 35-mm heterogeneously enhanced mass in the pancreas body. Endoscopic ultrasound-guided fine needle aspiration of the mass revealed a diffuse proliferation of atypical spindle cells in a fascicular arrangement. Because the histology was quite similar to the resected specimen of synovial sarcoma in 2009, the mass was suspected to be a metastasis from synovial sarcoma. Laparoscopic distal pancreatectomy with adjuvant adriamycin/ifosfamide chemotherapy was subsequently performed. Synovial sarcoma-specific SS18-SSX1 (synovial sarcoma translocation, chromosome 18-synovial sarcoma X1) or SS18-SSX2 chimera mRNA was detected in the resected specimen, confirming the diagnosis of metastasis from synovial sarcoma. The patient did well for 30 months without recurrence. Conclusion: This case suggests that pancreatic metastasis from synovial sarcoma can be successfully treated by metastasectomy with adjuvant chemotherapy.

Original languageEnglish
JournalMedicine (United States)
Volume95
Issue number39
DOIs
Publication statusPublished - 2016

All Science Journal Classification (ASJC) codes

  • Medicine(all)

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    Makino, Y., Shigekawa, M., Kegasawa, T., Suda, T., Yoshioka, T., Iwahashi, K., Ikezawa, K., Sakamori, R., Yakushijin, T., Kajihara, J., Tomimaru, Y., Eguchi, H., Imura, Y., Outani, H., Naka, N., Honma, K., Morii, E., Tatsumi, T., Hiramatsu, N., & Takehara, T. (2016). A case report of pancreatic metastasis from synovial sarcoma successfully treated by metastasectomy with adjuvant chemotherapy. Medicine (United States), 95(39). https://doi.org/10.1097/MD.0000000000004789