Case Report: Synovial sarcoma with diffuse myxoid stroma and complete absence of epithelial differentiation in the extremity
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By
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Tomohiro Miyazaki
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Naoki Oike
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Takashi Ariizumi
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Yudai Murayama
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Akira Ogose
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Hideaki Sugino
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Mai Nakamura
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Shuhei Kondo
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Yusuke Tani
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Hajime Umezu
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Hiroyuki Kawashima
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May 29, 2026
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Clinical Scorecard: Case Study: Diffuse Myxoid Stroma in Synovial Sarcoma Lacking Epithelial Differentiation in an Extremity
At a Glance
| Category | Detail |
|---|
| Condition | |
| Key Mechanisms | Defined by SS18–SSX fusion gene; presents with diffuse myxoid stroma, which complicates diagnosis. |
| Target Population | |
| Care Setting | |
Key Highlights
- Rare case of synovial sarcoma with diffuse myxoid stroma and absence of epithelial markers.
- Diagnosis confirmed by molecular identification of SS18–SSX1 fusion gene.
- Initial presentation included a 55-mm soft tissue tumor with atypical cells.
- Postoperative radiotherapy followed by local recurrence and lung metastasis.
Guideline-Based Recommendations
Diagnosis
- Utilize immunohistochemistry and molecular tests for accurate diagnosis.
Management
- Consider surgical excision followed by postoperative radiotherapy.
Monitoring & Follow-up
- Regular radiological follow-up for potential metastasis and recurrence.
Risks
- Potential for local recurrence and distant metastasis.
Patient & Prescribing Data
61-year-old woman with synovial sarcoma.
Initial management included marginal excision and postoperative radiotherapy; systemic therapy initiated after recurrence.
Clinical Best Practices
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