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©The Author(s) 2019. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Surg. Jan 27, 2019; 11(1): 27-33
Published online Jan 27, 2019. doi: 10.4240/wjgs.v11.i1.27
Management of primary retroperitoneal synovial sarcoma: A case report and review of literature
Aikaterini Mastoraki, Dimitrios Schizas, Ioannis S Papanikolaou, George Bagias, Nikolaos Machairas, George Agrogiannis, Theodore Liakakos, Nikolaos Arkadopoulos
Aikaterini Mastoraki, Ioannis S Papanikolaou, Nikolaos Arkadopoulos, 4th Department of Surgery, National and Kapodistrian University of Athens, Attikon University Hospital, Chaidari, Athens 12462, Greece
Dimitrios Schizas, Theodore Liakakos, 1st Department of Surgery, National and Kapodistrian University of Athens, Laikon Hospital, Athens 11527, Greece
George Bagias, Hannover Medical School, Clinic for General, Visceral and Transplant Surgery, Hannover 30625, Germany
Nikolaos Machairas, 3rd Department of Surgery, National and Kapodistrian University of Athens, Attikon University Hospital, Chaidari, Athens 12462, Greece
George Agrogiannis, 1st Department of Pathology, National and Kapodistrian University of Athens, Athens 11527, Greece
Author contributions: Mastoraki A, Papanikolaou IS and Arkadopoulos N designed the report; Mastoraki A, Schizas D and Bagias G collected the patient’s clinical data; Machairas N and Agrogiannis G provided relevant figures; Mastoraki A, Schizas D, Liakakos T and Arkadopoulos N analysed the data and wrote the paper.
Informed consent statement: Not provided as patient’s initials or characteristics are not exposed.
Conflict-of-interest statement: The authors declare that no conflict of interest exists.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Aikaterini Mastoraki, MD, PhD, Academic Research, Assistant Lecturer, Doctor, Lecturer, Surgeon, 4th Department of Surgery, National and Kapodistrian University of Athens, Attikon University Hospital, 1, Rimini Street, Athens 12462, Greece. kmastoraki@med.uoa.gr
Telephone: +0030-6932-577710 Fax: +0030-210-5326412
Received: November 3, 2018
Peer-review started: November 5, 2018
First decision: November 27, 2018
Revised: December 11, 2018
Accepted: December 29, 2018
Article in press: December 30, 2018
Published online: January 27, 2019
BACKGROUND
Synovial sarcoma (SS) is a rare type of soft tissue sarcoma that is usually developed from areas where synovial tissue exists, especially at the extremities. Nevertheless, several cases of retroperitoneal SS (RSS) have been described. We herein report a case of RSS presented in our institution.
CASE SUMMARY
A 69-year-old female patient was admitted with a large, palpable, firm mass in the right abdominal space SS. Computerized tomography scan depicted a concentric, sharply marinated retro-peritoneal lesion which was displacing the right kidney and the lower edge of the liver. Subsequently, the patient underwent surgical excision of the mass with additional right nephrectomy and resection of the right adrenal gland and a part of the diaphragm. The final histological diagnosis of the tumour was grade II monophasic RSS.
CONCLUSION
RSS is encountered in the biphasic type, the monophasic fibrous, and the monophasic epithelial category as well. Relevant clinical manifestations are not always documented at early stages. Therefore, the final diagnosis is posed after complete histological examination taking into consideration the results of immunochemistry and genetic analysis. Therapeutic approach happens often late when metastases at the lungs and the liver are apparent. Thus, 5-year survival rates remain low.
Core tip: Synovial sarcoma (SS) is a rare type of soft tissue sarcoma that is usually developed from areas where synovial tissue exists, especially at the extremities. Nevertheless, several cases of retroperitoneal SS (RSS) have been described. Diagnosis is accomplished after complete histological examination taking into consideration the results of immunochemistry and genetic analysis. Therapeutic approach happens often late when metastases at the lungs and the liver are apparent. Thus, 5-year survival rates remain low. Despite recent research on the therapeutic strategies against RSS, surgical resection appears the only potentially curative approach.
