Cancer Genetics and Epigenetics 2017, Vol.5, No.6, 28-32
31
the best of our knowledge, involvement of ventricle has not been reported to date. The present case involving the
lateral ventricle with the tentorium thickened may help us to better recognize the tumor. The types of tumors in
the ventricle make up a long list, including choroid plexus papilloma, meningioma, central neurocytoma,
astrocytoma and ependymoma. Radiologically, discriminating SS from other types of cancer is very difficult.
Nonetheless, they should be considered in the differential diagnosis.
Intracranial synovial sarcoma is very rare. Tumors are from periventricular dura tissues rather than synovial cells.
SS can appear as benign lesions with expansive smooth boundaries. SS is supposed to be taken into thought when
septations, hemorrhages, calcification and cystic components shown in the imaging studies. The clinical
presentation of head and neck SS correlates with the tumor region. Our patient presented with 2-month history of
headache owing to extension of the tumor mass in the left ventricle and slight intracranial hypertension. Clinically,
many patients are not indicated for surgery, because these ventricular tumors grow slowly, and are often
asymptomatic until they reach a relatively large size sufficient to create pressure on the adjacent structures, when
they cause symptoms or are identified incidentally. The most encountered symptom is headache, as seen in our
case. The tumor showed the predominance to exert pushing margins and was circumscribed by a fibrous
pseudocapsule, as they had slow growth history. With respect to our patient, the case presented with a
well-encapsulated mass in the left ventricle that infiltrates tentorium. The growth was similar in appearance to a
neoplasm originating from the dura within the lateral ventricle. Because of its smooth surface, along with marked
affiliation with dura, the growth was diagnosed pre-operationally as meningioma. In addition, the pronounced
mass effect on the surrounding temporal lobe along with the multiple cysts within the mass, the malignancy was
considered. Owing to the rarity of SS in the ventricle, misdiagnosis is common. In 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.
Authors’ contributions
Liang Zong-hui conceived and designed the work that led to the submission. Dou Ya-fang and Liang Zong-hui evaluated images and
analyzed data. Dou Ya-fang completed the writing of the article. Liang Zong-hui revised the paper. All authors participated in paper
writing and approved the final manuscript.
Acknowledgments
This work was supported by the Shanghai Jing’an District Health System talent training Plan discipline leader, project number
JWRC2014D04.
Reference
Al-Daraji W., Lasota J., Foss R., et al., Synovial sarcoma involving the head: analysis of 36 cases with predilection to the parotid and temporal regions. Am J
SurgPathol 2009; 33:1494–503
Alsharief A.N., Fageeh M., Alabdulkarim Y., Monophasic synovial sarcoma presenting as a primary ileal mass: a case report and review of the literature. J.
Med Case Rep 2012; 6: 83
Company Campins M.M., Morales R., Dolz C., et al., Primary monophasic synovial sarcoma of the duodenum confirmed by cytogenetic analysis with
demonstration of t (X;18): a case report. J Gastrointestin Liver Dis 2009; 18: 89–93
Crowson M.G., Lalich I., Keeney M.G., et al., Clinicopathologic factors and adjuvant treatment effects on survival in adult head and neck synovial cell sarcoma.
Head Neck 2015; 37: 375-380
Cummings N.M., Desai S., Thway K., et al., Cystic primary pulmonary synovial sarcoma presenting as recurrent pneumothorax: report of 4 cases. Am J
SurgPathol 2010; 34: 1176–9
Dhawan A., Shenoy A.M.
，
Chavan P., et al., Synovial sarcoma of the infratemporal fossa with extension into the oral cavity-a rare presentation and literature
review. J Oral MaxillofacSurg 2012
；
70: 2923-2929
Eravci F.C., Duzlu M., Zorlu M.E., et al., Excision of recurrent synovial sarcoma of the infratemporal fossa. Kulak Burun Bogaz Ihtis Derg 2016; 26: 293-9
Fisher C., Synovial sarcoma. Ann DiagnPathol 1998; 2:401–21
