Late solitary bone metastasis of a primary pulmonary synovial sarcoma with SYT-SSX1 translocation type: case report with a long follow-up

Virchows Arch. 2005 Mar;446(3):310-5. doi: 10.1007/s00428-004-1174-2. Epub 2005 Jan 25.

Abstract

Primary synovial sarcoma outside its classical presentation in para-articular soft tissue of young patients is rare but regularly reported. One of the rarest primary locations is the lung. We describe a 73-year-old female patient who presented with a solitary malignant bone tumor 8 years after the resection of a lung neoplasm. The bone tumor was classified as an osteosarcoma and the lung tumor as an atypical carcinoid tumor at their first respective diagnostic work-ups. The resection of the affected humerus with allograft and endoprosthesis implantation followed. Reevaluation of the tumor samples at the time of the local recurrence of the bone tumor 6 years following the initial symptoms of the bone tumor lead to the reclassification of both specimens as synovial sarcomas. Both neoplasms contained the SYT-SSX1 type of the diagnostic translocation t(X;18) as detected by the reverse-transcription polymerase chain reaction analysis. The patient died 14 years after the resection of the primary synovial sarcoma of the lung and 6 years following the occurrence of the bone metastasis. This prolonged clinical course is uncommon for the SYT-SSX1 translocation, which, in other locations, is usually associated with an unfavorable prognosis.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Bone Neoplasms / genetics
  • Bone Neoplasms / pathology
  • Bone Neoplasms / secondary*
  • Diagnosis, Differential
  • Diagnostic Errors
  • Female
  • Humans
  • Immunohistochemistry
  • Lung Neoplasms / genetics*
  • Lung Neoplasms / pathology*
  • Oncogene Proteins, Fusion
  • Osteosarcoma / pathology
  • Reverse Transcriptase Polymerase Chain Reaction
  • Sarcoma, Synovial / genetics*
  • Sarcoma, Synovial / pathology
  • Sarcoma, Synovial / secondary*
  • Time Factors
  • Translocation, Genetic

Substances

  • Oncogene Proteins, Fusion
  • SYT-SSX fusion protein