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. 2016:2016:5608315.
doi: 10.1155/2016/5608315. Epub 2016 May 9.

Primary Intracranial Synovial Sarcoma

Mohit Patel  1 , Luyuan Li  1 , Ha Son Nguyen  1 , Ninh Doan  1 , Grant Sinson  1 , Wade Mueller  1
Affiliations

Primary Intracranial Synovial Sarcoma

Mohit Patel et al. Case Rep Neurol Med. 2016.

Abstract

Background. Synovial sarcoma is an aggressive soft tissue sarcoma with uncertain histological origin. The pathology frequently presents as a localized disease, especially near large joints around the knee and thigh. Intracranial disease, which is rare, has been reported as metastasis from synovial sarcoma. We report a case with no obvious primary extracranial pathology, suggesting primary intracranial disease; this has not been reported in the literature. Case Description. A 21-year-old male, with a prior right skull lesion resection for atypical spindle cell neoplasm, presented with headaches, gait instability, left arm weakness, and left homonymous hemianopsia. CT of head demonstrated a right parietal hemorrhagic lesion with mass effect, requiring surgical decompression. Histopathology revealed synovial sarcoma. FISH analysis noted the existence of the t(X;18)(p11.2;q11.2) chromosomal translocation. PET scan did not show other metastatic disease. He underwent stereotactic radiotherapy and adjuvant chemotherapy. At 2-year follow-up, he remained nonfocal without recurrence. Conclusion. We report the first known case of primary intracranial synovial sarcoma. Moreover, we stress that intracranial lesions may have a tendency for hemorrhage, requiring urgent lifesaving decompression.

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Figures

Figure 1
Figure 1
Axial CT of head for patient demonstrates right parietal heterogeneous, hyperdense mass with a large medial hematoma.
See this image and copyright information in PMC

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