Radiation-associated synovial sarcoma: clinicopathologic and molecular analysis of two cases

Mod Pathol. 2002 Sep;15(9):998-1004. doi: 10.1097/01.MP.0000026616.41545.FF.

Abstract

Development of a soft-tissue sarcoma is an infrequent but well-known long-term complication of radiotherapy. Malignant fibrous histiocytomas, extraskeletal osteosarcomas, fibrosarcomas, malignant peripheral nerve sheath tumors, and angiosarcomas are most frequently encountered. Radiation-associated synovial sarcomas are exceptional. We report the clinicopathologic, immunohistochemical, and molecular features of two radiation-associated synovial sarcomas. One tumor developed in a 42-year-old female 17 years after external irradiation was given for breast carcinoma; the other occurred in a 34-year-old female who was irradiated at the age of 7 years for a nonneoplastic condition of the left hand. Both lesions showed morphologic features of monophasic spindle cell synovial sarcoma, were immunoreactive for cytokeratins, epithelial membrane antigen, CD99, CD117 (c-kit), and bcl-2 and bore the t(X;18) (SYT-SSX1) translocation. We conclude that synovial sarcoma has to be added to the list of radiation-associated soft-tissue sarcomas.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Female
  • Humans
  • Immunohistochemistry
  • Lung Neoplasms / secondary
  • Neoplasm Proteins / genetics
  • Neoplasms, Radiation-Induced / genetics
  • Neoplasms, Radiation-Induced / metabolism
  • Neoplasms, Radiation-Induced / pathology*
  • Neoplasms, Second Primary / genetics
  • Neoplasms, Second Primary / metabolism
  • Neoplasms, Second Primary / pathology*
  • Repressor Proteins / genetics
  • Reverse Transcriptase Polymerase Chain Reaction
  • Sarcoma, Synovial / genetics
  • Sarcoma, Synovial / metabolism
  • Sarcoma, Synovial / pathology*
  • Soft Tissue Neoplasms / genetics
  • Soft Tissue Neoplasms / metabolism
  • Soft Tissue Neoplasms / pathology*
  • Translocation, Genetic

Substances

  • Neoplasm Proteins
  • Repressor Proteins
  • synovial sarcoma X breakpoint proteins