Synovial sarcoma, histologically mimicking primitive neuroectodermal tumor/Ewing's sarcoma at distant sites

Fumiaki Masui, Yoshihiro Matsuno, Ryohei Yokoyama, Yukihiro Nakanishi, Tadashi Hasegawa, Yae Kanai, Yasuo Beppu, Setsuo Hirohashi, Katsuyuki Fujii, Tadakazu Shimoda

研究成果: Article

19 引用 (Scopus)

抄録

We report a case of synovial sarcoma (SS) showing unusual histology at distant sites. A 47-year-old man was aware of a tumor on the sole of his left foot. After preoperative chemotherapy with a diagnosis of SS, wide excision was performed. During postoperative chemotherapy, multiple tumorous lesions developed in the bone (including the whole spine) and both lungs. The patient died 1 year later. Histologically, the excised tumor of the foot showed a biphasic cellular pattern typical of SS, whereas at autopsy the bone and lung lesions were composed only of undifferentiated small round cells with cytoplasmic fibrillar processes. Homer-Wright rosettes were also observed. Immunohistochemically, 80% of the bone and lung tumor cells expressed MIC2 protein homogeneously. To clarify whether the bone and lung round cell tumors were metastatic lesions or second malignancies, especially primary primitive neuroectodermal tumor (PNET)/Ewing's sarcoma (ES), we performed reverse transcription-polymerase chain reaction (RT-PCR) analysis of tumor type-specific fusion gene transcripts. The SYT/SSX fusion transcript was identified in both the foot and lung lesions, whereas the EWS/FLI1 transcript was not detected in either lesion. Therefore, we concluded that the multiple bone and lung tumors were poorly differentiated metastatic tumors, which arose from the SS of the foot. We also conclude that the identification of chimeric fusion transcripts can be successfully applied to poorly differentiated sarcomas and will help in the differential diagnosis of tumors that cannot be distinguished by conventional morphological examinations. Also, it should be remembered that cytoplasmic staining for MIC2 protein may occur in sarcomas other than PNET/ES.

元の言語English
ページ(範囲)438-441
ページ数4
ジャーナルJapanese Journal of Clinical Oncology
29
発行部数9
出版物ステータスPublished - 1999 9
外部発表Yes

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Synovial Sarcoma
Primitive Neuroectodermal Tumors
Ewing's Sarcoma
Lung
Foot
Neoplasms
Bone and Bones
Sarcoma
Drug Therapy
Second Primary Neoplasms
Gene Fusion
Reverse Transcription
Autopsy
Histology
Spine
Differential Diagnosis
Staining and Labeling
Polymerase Chain Reaction

ASJC Scopus subject areas

  • Oncology

これを引用

Masui, F., Matsuno, Y., Yokoyama, R., Nakanishi, Y., Hasegawa, T., Kanai, Y., ... Shimoda, T. (1999). Synovial sarcoma, histologically mimicking primitive neuroectodermal tumor/Ewing's sarcoma at distant sites. Japanese Journal of Clinical Oncology, 29(9), 438-441.

Synovial sarcoma, histologically mimicking primitive neuroectodermal tumor/Ewing's sarcoma at distant sites. / Masui, Fumiaki; Matsuno, Yoshihiro; Yokoyama, Ryohei; Nakanishi, Yukihiro; Hasegawa, Tadashi; Kanai, Yae; Beppu, Yasuo; Hirohashi, Setsuo; Fujii, Katsuyuki; Shimoda, Tadakazu.

:: Japanese Journal of Clinical Oncology, 巻 29, 番号 9, 09.1999, p. 438-441.

研究成果: Article

Masui, F, Matsuno, Y, Yokoyama, R, Nakanishi, Y, Hasegawa, T, Kanai, Y, Beppu, Y, Hirohashi, S, Fujii, K & Shimoda, T 1999, 'Synovial sarcoma, histologically mimicking primitive neuroectodermal tumor/Ewing's sarcoma at distant sites', Japanese Journal of Clinical Oncology, 巻. 29, 番号 9, pp. 438-441.
Masui, Fumiaki ; Matsuno, Yoshihiro ; Yokoyama, Ryohei ; Nakanishi, Yukihiro ; Hasegawa, Tadashi ; Kanai, Yae ; Beppu, Yasuo ; Hirohashi, Setsuo ; Fujii, Katsuyuki ; Shimoda, Tadakazu. / Synovial sarcoma, histologically mimicking primitive neuroectodermal tumor/Ewing's sarcoma at distant sites. :: Japanese Journal of Clinical Oncology. 1999 ; 巻 29, 番号 9. pp. 438-441.
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abstract = "We report a case of synovial sarcoma (SS) showing unusual histology at distant sites. A 47-year-old man was aware of a tumor on the sole of his left foot. After preoperative chemotherapy with a diagnosis of SS, wide excision was performed. During postoperative chemotherapy, multiple tumorous lesions developed in the bone (including the whole spine) and both lungs. The patient died 1 year later. Histologically, the excised tumor of the foot showed a biphasic cellular pattern typical of SS, whereas at autopsy the bone and lung lesions were composed only of undifferentiated small round cells with cytoplasmic fibrillar processes. Homer-Wright rosettes were also observed. Immunohistochemically, 80{\%} of the bone and lung tumor cells expressed MIC2 protein homogeneously. To clarify whether the bone and lung round cell tumors were metastatic lesions or second malignancies, especially primary primitive neuroectodermal tumor (PNET)/Ewing's sarcoma (ES), we performed reverse transcription-polymerase chain reaction (RT-PCR) analysis of tumor type-specific fusion gene transcripts. The SYT/SSX fusion transcript was identified in both the foot and lung lesions, whereas the EWS/FLI1 transcript was not detected in either lesion. Therefore, we concluded that the multiple bone and lung tumors were poorly differentiated metastatic tumors, which arose from the SS of the foot. We also conclude that the identification of chimeric fusion transcripts can be successfully applied to poorly differentiated sarcomas and will help in the differential diagnosis of tumors that cannot be distinguished by conventional morphological examinations. Also, it should be remembered that cytoplasmic staining for MIC2 protein may occur in sarcomas other than PNET/ES.",
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AU - Masui, Fumiaki

AU - Matsuno, Yoshihiro

AU - Yokoyama, Ryohei

AU - Nakanishi, Yukihiro

AU - Hasegawa, Tadashi

AU - Kanai, Yae

AU - Beppu, Yasuo

AU - Hirohashi, Setsuo

AU - Fujii, Katsuyuki

AU - Shimoda, Tadakazu

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N2 - We report a case of synovial sarcoma (SS) showing unusual histology at distant sites. A 47-year-old man was aware of a tumor on the sole of his left foot. After preoperative chemotherapy with a diagnosis of SS, wide excision was performed. During postoperative chemotherapy, multiple tumorous lesions developed in the bone (including the whole spine) and both lungs. The patient died 1 year later. Histologically, the excised tumor of the foot showed a biphasic cellular pattern typical of SS, whereas at autopsy the bone and lung lesions were composed only of undifferentiated small round cells with cytoplasmic fibrillar processes. Homer-Wright rosettes were also observed. Immunohistochemically, 80% of the bone and lung tumor cells expressed MIC2 protein homogeneously. To clarify whether the bone and lung round cell tumors were metastatic lesions or second malignancies, especially primary primitive neuroectodermal tumor (PNET)/Ewing's sarcoma (ES), we performed reverse transcription-polymerase chain reaction (RT-PCR) analysis of tumor type-specific fusion gene transcripts. The SYT/SSX fusion transcript was identified in both the foot and lung lesions, whereas the EWS/FLI1 transcript was not detected in either lesion. Therefore, we concluded that the multiple bone and lung tumors were poorly differentiated metastatic tumors, which arose from the SS of the foot. We also conclude that the identification of chimeric fusion transcripts can be successfully applied to poorly differentiated sarcomas and will help in the differential diagnosis of tumors that cannot be distinguished by conventional morphological examinations. Also, it should be remembered that cytoplasmic staining for MIC2 protein may occur in sarcomas other than PNET/ES.

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