SYT-SSX2 variant of primary pulmonary synovial sarcoma with focal expression of CD117 (c-Kit) protein and a poor clinical outcome

Arch Pathol Lab Med. 2003 Apr;127(4):e201-4. doi: 10.5858/2003-127-e201-SVOPPS.

Abstract

Pulmonary synovial sarcoma is a rare neoplasm recently recognized as a distinct entity and characterized by t(X;18) translocation and production of at least 2 fusion genes, SYT-SSX1 and SYT-SSX2. We report a case of primary pulmonary synovial sarcoma with the SYT-SSX2 phenotype and a rapidly progressive downhill course. Previous reports have suggested that the soft tissue synovial sarcomas with SYT-SSX2 phenotype have a favorable clinical outcome. To the best of our knowledge, this is also the first report of CD117 (c-Kit) expression in a pulmonary synovial sarcoma. A 45-year-old woman presented with left chest pain and was found to have a left lower lobe tumor that was originally diagnosed as a sarcomatoid carcinoma. After the patient underwent chemotherapy and brachytherapy, the specimen from a left pneumonectomy showed a large spindle cell tumor, which was reclassified as a synovial sarcoma based on the results of immunophenotyping and molecular genetic studies. Differentiation between sarcoma and carcinosarcoma is crucial for implementing appropriate therapy. Furthermore, if the tumor expresses c-Kit, it may respond to target-based therapy.

Publication types

  • Case Reports

MeSH terms

  • Biomarkers, Tumor / genetics
  • Brain Neoplasms / genetics
  • Brain Neoplasms / metabolism
  • Brain Neoplasms / secondary
  • Fatal Outcome
  • Female
  • Genetic Variation / genetics*
  • Humans
  • Lung Neoplasms / diagnosis*
  • Lung Neoplasms / genetics*
  • Lung Neoplasms / metabolism
  • Lung Neoplasms / pathology
  • Middle Aged
  • Oncogene Proteins, Fusion / genetics*
  • Phenotype
  • Proto-Oncogene Proteins c-kit / biosynthesis*
  • Sarcoma, Synovial / diagnosis*
  • Sarcoma, Synovial / genetics*
  • Sarcoma, Synovial / metabolism
  • Sarcoma, Synovial / secondary

Substances

  • Biomarkers, Tumor
  • Oncogene Proteins, Fusion
  • SYT-SSX fusion protein
  • Proto-Oncogene Proteins c-kit