Cancer Genetics and Epigenetics 2017, Vol.5, No.6, 28-32
28
Research Report Open Access
Intraventricular Synovial Sarcoma: A Case Report and Literature Review
Dou Yafang, Liang Zonghui
Department of radiology, Jing’an District Center Hospital of Fudan University, China
Corresponding author email
Cancer Genetics and Epigenetics, 2017, Vol.5, No.6 doi
Received: 05 Dec., 2017
Accepted: 12 Dec., 2017
Published: 29 Dec., 2017
Copyright © 2017
Dou and Liang, This is an open access article published under the terms of the Creative Commons Attribution License, which permits
unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Preferred citation for this article:
Dou Y.F., and Liang Z.G., 2017, Intraventricular synovial sarcoma: a case report and literature review, Cancer Genetics and Epigenetics, 5(6): 28-32 (doi:
Abstract
Synovial sarcoma (SS) is a high-grade malignant neoplasm. SS is a rare cancer type, which is primarily derived from the
soft tissues of the lower extremities. The head and neck region is quite an extremely rare location, particularly the ventricle.The
origin of SS remains a challenge, which along with its propensity to present clinical features mimicking other neoplasms within the
common site, can result in significant diagnostic difficulty.Herein, we present a case of 40-year-old male SS located in the left
ventricle with information including manifestation, imaging and histopathological features.On CT, approximately 30% of cases
appear detectable calcification, which may be focal or dispersed throughout the tumor, often with a fine, stippled, or opaque
appearance. MRI revealed a heterogeneous expansive and multi-lobular mass involving left ventricle, with intense and heterogeneous
enhancement. Tentorium was thickened and enhanced. Small cystic changes were found in the peripheral part of the tumor with no
enhancement. . Radiologically, discriminating SS from other types of cancer is very difficult. Nonetheless, they should be considered
in the differential diagnosis. Owing to the rarity of SS in the ventricle, misdiagnosis is commonIn summary, we report one SS in the
ventricle, the unusual location, to remind the radiologist to make it come to our mind for future work.
Keywords
Synovial sarcoma; MRI; Diagnosis; Intraventricular neoplasm
Background
Synovial sarcoma (SS) is a high-grade malignant neoplasm, representing 5%-10% of all soft tissue sarcomas. SS
occurs over a wide age range, predominantly distributed in adolescents and young adults. There is a slight male
preponderance, with a male: female ratio of approximately 1.2:1. Accounting for over 85% occurring in the
extremities, especially encountered in large joint, SS was originally noted for its propensity for soft tissues derived
from synovial cell. Actually, SS could be found throughout the body. The head and neck region is quite an
extremely rare location, particularly the ventricle. The origin of SS remains a challenge, which along with its
propensity to present clinical features mimicking other neoplasms within the common site, can result in significant
diagnostic difficulty. Herein, we present a case of SS located in the left ventricle with information including
manifestation, imaging and histopathological features. To our knowledge, this is the first reported case of SS
involving ventricle associated with tentorium invasion. We discuss the related diagnostic aspects.
1 Case Report
1.1 History and examination
This 40-year-old male complaining of a 2-month history of headache was referred to our Neurosurgery
Department. Neurological examination revealed no other deficits. Preoperative MR imaging demonstrated the
presence of a large heterogeneously enhancing mass centered in the left ventricle. The lesion has evolved toward
the tentorium; intracranial extension was present. There was marked mass effect on the left temporal lobe. A
malignant meningioma was suspected as the pre-operative diagnosis.
1.2 Imaging features
Our case is a middle-aged male presenting a comparatively short detectable medical history. MRI identified a
large mass in the left ventricle with significant enhancement. The tumor was expansive but with well-defined edge,
and had the typical imaging features of meningioma with tentorium involvement. Owing to minimal cystic lesions
in the peripheral part of the tumor, and the great mass effect affecting the left temporal lobe, a malignant
meningioma was supposed to be taken into optimal consideration (Figure 1).
