Primary synovial sarcoma of the kidney: a case report of complete pathological response at a Lebanese tertiary care center

BMC Urol. 2018 May 11;18(1):40. doi: 10.1186/s12894-018-0358-z.

Abstract

Background: Primary synovial sarcoma of the kidney is a rare type of soft tissue sarcoma. Its presenting features can resemble those of other renal tumors; rendering its early diagnosis, a dilemma. Several cases of renal synovial sarcoma have been reported in the literature with varying treatment options and outcomes. This article describes a rare case of primary renal synovial sarcoma and reviews all cases in the literature.

Case presentation: A 26-year-old male presented with flank pain and hematuria. Initially diagnosed with Wilm's tumor, revision of pathology and histology, along with the immunohistochemical profile, confirmed, nevertheless, the diagnosis of primary monophasic synovial sarcoma of the kidney with the SYT-SSX2 fusion transcript. Follow-up, post nephrectomy, revealed recurrence within the lungs and at the surgical bed. Surgical resection followed by adjuvant chemotherapy regimen constituting of Doxorubicin and Ifosfamide, achieved complete pathological response.

Conclusion: In this case report, we emphasize the need for accurate diagnosis and prompt treatment. We propose multimodality treatment approach including surgery along with anthracycline-based chemotherapy to induce complete remission.

Keywords: Doxorubicin; Ifosfamide; Pathological response; SYT-SSX; Survival; Synovial sarcoma.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Adult
  • Antineoplastic Combined Chemotherapy Protocols / administration & dosage
  • Combined Modality Therapy / methods
  • Humans
  • Kidney Neoplasms / diagnosis*
  • Kidney Neoplasms / pathology
  • Kidney Neoplasms / therapy*
  • Lebanon
  • Male
  • Sarcoma, Synovial / diagnosis*
  • Sarcoma, Synovial / pathology
  • Sarcoma, Synovial / therapy*
  • Tertiary Care Centers*
  • Treatment Outcome