Primary Monophasic Synovial Sarcoma of the Tonsil: Immunohistochemical and Molecular Study of a Case and Review of the Literature

Overview

Journal Head Neck Pathol

Specialties Oncology
Pathology

Date 2013 Apr 9

PMID 23564530

Citations 3

Authors

Danny Soria-Cespedes

Aldo Ivan Galvan-Linares

Cuauhtemoc Oros-Ovalle

Francisco Gaitan-Gaona

Carlos Ortiz-Hidalgo

Affiliations

Soon will be listed here.

Abstract

Synovial sarcoma (SS) arises primarily in the lower extremities with a predilection for sites in proximity to large joints, such as the knee. It rarely occurs in the head and neck region, and the tonsil is an unusual site for the tumor, with only eight previously published cases in this anatomical site. We present a case of a primary monophasic SS arising in the right tonsil in a 63-year-old male. His medical history was noncontributory. Immunohistochemistry showed that cytokeratin OSCAR, EMA, Bcl-2, vimentin, PGP 9.5, and TLE1 were diffusely positive. A molecular analysis using RT-PCR indicated that the patient was positive for the SYT/SSX1 fusion transcript. A diagnosis of monophasic synovial sarcoma of the tonsil was made.

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References

Thorson J, Weigelin H, Ruiz R, Howard J, Lucas D . Identification of SYT-SSX transcripts from synovial sarcomas using RT-multiplex PCR and capillary electrophoresis. Mod Pathol. 2006; 19(5):641-7. DOI: 10.1038/modpathol.3800558. View

Coindre J, Pelmus M, Hostein I, Lussan C, Bui B, Guillou L . Should molecular testing be required for diagnosing synovial sarcoma? A prospective study of 204 cases. Cancer. 2003; 98(12):2700-7. DOI: 10.1002/cncr.11840. View

Amary M, Berisha F, Bernardi F, Herbert A, James M, Reis-Filho J . Detection of SS18-SSX fusion transcripts in formalin-fixed paraffin-embedded neoplasms: analysis of conventional RT-PCR, qRT-PCR and dual color FISH as diagnostic tools for synovial sarcoma. Mod Pathol. 2007; 20(4):482-96. DOI: 10.1038/modpathol.3800761. View

Fisher C . Synovial sarcoma: ultrastructural and immunohistochemical features of epithelial differentiation in monophasic and biphasic tumors. Hum Pathol. 1986; 17(10):996-1008. DOI: 10.1016/s0046-8177(86)80083-1. View

Fisher C . Synovial sarcoma. Ann Diagn Pathol. 1999; 2(6):401-21. DOI: 10.1016/s1092-9134(98)80042-7. View

Valente A, Tull J, Zhang S . Specificity of TLE1 expression in unclassified high-grade sarcomas for the diagnosis of synovial sarcoma. Appl Immunohistochem Mol Morphol. 2012; 21(5):408-13. DOI: 10.1097/PAI.0b013e318279f9ee. View

Raney R . Synovial sarcoma in young people: background, prognostic factors, and therapeutic questions. J Pediatr Hematol Oncol. 2005; 27(4):207-11. DOI: 10.1097/01.mph.0000161764.60798.60. View

Terry J, Saito T, Subramanian S, Ruttan C, Antonescu C, Goldblum J . TLE1 as a diagnostic immunohistochemical marker for synovial sarcoma emerging from gene expression profiling studies. Am J Surg Pathol. 2007; 31(2):240-6. DOI: 10.1097/01.pas.0000213330.71745.39. View

Ishiki H, Miyajima C, Nakao K, Asakage T, Sugasawa M, Motoi T . Synovial sarcoma of the head and neck: rare case of cervical metastasis. Head Neck. 2008; 31(1):131-5. DOI: 10.1002/hed.20856. View

10.

ten Heuvel S, Hoekstra H, Suurmeijer A . Diagnostic accuracy of FISH and RT-PCR in 50 routinely processed synovial sarcomas. Appl Immunohistochem Mol Morphol. 2008; 16(3):246-50. DOI: 10.1097/PAI.0b013e31815349f5. View

11.

Vogel U, Wehrmann M, Eichhorn W, Bultmann B, Stiegler M, Wagner W . Molecular and clinicopathological findings in a tonsillar synovial sarcoma. A case study and review of the literature. Head Neck Pathol. 2010; 4(3):257-60. PMC: 2923310. DOI: 10.1007/s12105-010-0190-6. View

12.

Shmookler B, ENZINGER F, Brannon R . Orofacial synovial sarcoma: a clinicopathologic study of 11 new cases and review of the literature. Cancer. 1982; 50(2):269-76. DOI: 10.1002/1097-0142(19820715)50:2<269::aid-cncr2820500217>3.0.co;2-7. View

13.

Rangheard A, Vanel D, Viala J, Schwaab G, Casiraghi O, Sigal R . Synovial sarcomas of the head and neck: CT and MR imaging findings of eight patients. AJNR Am J Neuroradiol. 2001; 22(5):851-7. PMC: 8174948. View

14.

Engelhardt J, Leafstedt S . Synovial sarcoma of tonsil and tongue base. South Med J. 1983; 76(2):243-4. DOI: 10.1097/00007611-198302000-00025. View

15.

Sultan I, Rodriguez-Galindo C, Saab R, Yasir S, Casanova M, Ferrari A . Comparing children and adults with synovial sarcoma in the Surveillance, Epidemiology, and End Results program, 1983 to 2005: an analysis of 1268 patients. Cancer. 2009; 115(15):3537-47. DOI: 10.1002/cncr.24424. View

16.

Meer S, Coleman H, Altini M . Oral synovial sarcoma: a report of 2 cases and a review of the literature. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2003; 96(3):306-15. DOI: 10.1016/s1079-2104(03)00209-9. View

17.

Villaroel-Salinas J, Campos-Martinez J, Ortiz-Hidalgo C . Synovial sarcoma of the tongue confirmed by molecular detection of the SYT-SSX2 fusion gene transcript. Int J Surg Pathol. 2011; 20(4):386-9. DOI: 10.1177/1066896911424897. View

18.

Pretto D, Barco R, Rivera J, Neel N, Gustavson M, Eid J . The synovial sarcoma translocation protein SYT-SSX2 recruits beta-catenin to the nucleus and associates with it in an active complex. Oncogene. 2006; 25(26):3661-9. DOI: 10.1038/sj.onc.1209413. View

19.

Fraga M, Berdasco M, Ballestar E, Ropero S, Lopez-Nieva P, Lopez-Serra L . Epigenetic inactivation of the Groucho homologue gene TLE1 in hematologic malignancies. Cancer Res. 2008; 68(11):4116-22. DOI: 10.1158/0008-5472.CAN-08-0085. View

20.

Kosemehmetoglu K, Vrana J, Folpe A . TLE1 expression is not specific for synovial sarcoma: a whole section study of 163 soft tissue and bone neoplasms. Mod Pathol. 2009; 22(7):872-8. DOI: 10.1038/modpathol.2009.47. View