Synovial Sarcoma with Massive Myxoid Feature - A Case Report -
최준혁, 신덕섭, 배영경, 김미진, 심영란, 정지영,
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최준혁 ( Choi Joon-Hyuk )
영남대학교 의과대학 병리학교실
신덕섭 ( Shin Duk-Seop )
영남대학교 의과대학 정형외과학교실
배영경 ( Bae Young-Kyung )
영남대학교 의과대학 병리학교실
김미진 ( Kim Mi-Jin )
영남대학교 의과대학 병리학교실
심영란 ( Shim Young-Ran )
영남대학교 의과대학 병리학교실
정지영 ( Jung Jee-Young )
영남대학교 의과대학 진단방사선과학교실
KMID : 0357920050390040273
Abstract
Focal myxoid change in synovial sarcoma is not uncommon, although the presence of predominantly myxoid stroma is very rare. Recognition of synovial sarcomas with massive myxoid feature is important because these can easily be mistaken for other myxoid soft tissue neoplasms. We report a case of a synovial sarcoma with massive myxoid feature in the left thigh of a 54-year-old woman. Wide excision of an 8.5×7.0×5.0 cm, well-circumscribed and lobulated tumor was performed. The cut surface was gray, soft, and myxoid. Histological examination showed proliferation of spindle cells in the predominantly myxoid stroma. There were small areas with features more typical of synovial sarcoma, including uniform, spindled cells with fascicular growth patterns, collagenous stroma, mast cell infiltration, and hemangiopericytoma-like vascular patterns. Immunohistochemical examination showed focal positivity of the tumor cells for epithelial membrane antigen (EMA). Tumor cells were all negative for cytokeratin (AE1/AE3), cytokeratin 7, S-100 protein, smooth muscle actin, and desmin. Ultrastructurally, tumor cells showed desmosomes and microvilli. Our case underscores that, in order to make a correct diagnosis, immunohistochemical and ultrastructural examination is essential.
키워드
Synovial sarcoma;Soft tissue;Myxoid;Sarcoma
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