Synovial sarcoma of the sellar region

Abstract

Primary sarcomas of the sellar region are uncommon, although a wide variety have been reported. To date, no cases of primary synovial sarcoma have been described as occurring at this site. We report an immunohistochemically and molecular genetically confirmed primary synovial sarcoma involving the sellar/parasellar region and cavernous sinus in an adult male. Subtotal resection and radiosurgery proved to be efficacious. The spectrum of primary sellar region sarcomas is summarized.

Fig. 1

Contrast-enhanced CT reveals a right sellar and parasellar mass. Calcification is seen in the lesion.

Fig. 2

Axial contrast MRI shows a right sellar and parasellar mass (A). Coronal contrast MRI identifies optic nerve compression (B). MR angiography shows narrowing of the intracavernous carotid artery (C).

Fig. 3

The histologically biphasic tumor featured a pseudopapillary epithelial component (A) and sheets of monotonous spindle cells enmeshed in collagen (B). Hematoxylin and eosin staining; original magnification ×160 (A) and ×250 (B).

Fig. 4

Immunohistochemistry revealed both cytoplasmic keratin reactivity (A) and membrane staining for epithelial membrane antigen (B). Original magnification ×250 for A and B.