Seyran YİĞİT, Tuğba DOĞRULUK, Mine TUNAKAN, Umur YENSEL

Retroperitoneal sinovyal sarkom: Olgu sunumu

68 yaşında kadın hasta kasık ve karın ağrısı nedeniyle izmir Atatürk Eğitim ve Araştırma Hastanesi 1. Kadın - Doğum Kliniğine başvurdu. Radyolojik görüntüleme yöntemlerinden direkt graft ve BT incelemesinde douglastan köken alan ve retroperitona uzanım gösteren kistik, kısmen solid özellikte kitle saptandı. Tümör, histopatolojik ve immunohistokimyasal bulgular eşliğinde retroperitoneal monofazik fibröz sinovyal sarkom olarak değerlendirildi. Monofazik fibröz sinovyal sarkom, bu lokalizasyonda diğer iğ hücreli mezankimal tümörler ile ayırıcı tanı güçlükleri yaratması açısından literatür eşliğinde tartışıldı.

Anahtar Kelimeler:

Tomografi, x-ışınlı bilgisayarlı, Sarkom, sinoviyal, Kadın, Yaşlı, Tanı, ayırıcı

Retroperitoneal synovial sarcoma: A case report

A 68 year old woman with a history of abdominal and inguinal pain admitted to 1st Gynecology and Obstetric Clinic of izmir Atatürk Education and Traning Hospital. Radiological imaging with plain X rays and CT showed a cystic, partially solid mass originating from cul de sac and extending to retro- peritoneum. Histopathological and immunohistochemical features showed that this retroperitoneal tumor was a conventional monophasic fibrous synovial sarcoma. We discussed the differantial diagnosis of monophasic fibrous synovial sarcoma in this localisation with other spindle cell sarcomas by the help of associated literature.

Keywords:

Tomography, X-Ray Computed, Sarcoma, Synovial, Female, Aged, Diagnosis, Differential,

PDF

___

1. Weiss SW, Goldblum JR. Malignant soft tissue tumors of uncertain type. İn Enzinger and Weiss' s Soft Tissue Tumors. 4th edition, St. Loise Mosby, 2001: 1483-1509.
2. Kempson RL, Flecher CDM, Evans HL, Hendrichson MR, et al. Tumors of uncertain diferentiation and those in Which diferentiation, is nonmesenchymai. İn Juan Rosai (ed) Atlas of Tumor Pathology tumors of the soft Tissue Third series, fascicle 30, Washington DC, AFIP, 1998: 472-492.
3. Machen SK, Easly KA, Goldblum JR. Synovial sarcoma of the extremites. A elinicipathologic study of 34 cases; ineluding semiquantitative analysis oî spindled, epithelial, and poorly differentiated areas. Am J Surg Pathol 1999 ;23 : 268-275.
4. Fetsch JF, Meis JM. Synovial sarcoma of the abdominal wall. Cancer 1993; 72: 469-477.
5. Shmookler BM. Retroperitonial synovial sarcoma. A report of four cases. Am J Clin Pathol 1982; 77: 686-691.
6. Argani P, Faria PA, Epstein Jl, Reuter VE, et al. Primary renal synovia! sarcoma. Molecular and morphologic delination of an entity previously ineluded among embryonal sareomas of the kidney. Am J Pathol 2000; 24: 1087-1096.
7. Winnepenninckx V, Vos R De, Rychter MD.Samson I, et al. Calcifying/ossifying synovial sarcoma shows t(X;18) with SSX2 involment and mitocondrial calcifications. Histopathology 2001; 38: 14-145.
8. Milchgrup S, Mnaymneh LG, Dorfman HD, Saavedra JA. Synovial sarcoma with extensive osteoid and bone formation. Am J Surg Pathol 1993; 17 :357-363.
9. Frane JF, Bertoni F, Flecther CDM. Myxoid synovial sarcoma: An underappreciated morphologic subset. Modern Pathology 1999; 12:456-462.
10. Smith TA, Machen SK, Ficher C, Goldblum JR. Usefullness of cytokeratın subsets for distinguishing monophasıc synovial sarcoma from malignant peripherai nerve sheath tumor. Am J Pathol 1999; 12:641-648.
11. Suster S, Fisher C, Moran CA . Expression of bci-2 oncoprotein in benign and malignant spindle celi tumors of soft tissue, skin, serosal surface, and gastroitestinal tract. Am J Surg Pathol 1998; 22 (7): 863-872.