Radiation-associated Synovial Sarcoma Arising in the Digestive Tract: A Case Report and Literature Review

Authors

  • Khadega A. Abuelgasim Department of Internal Medicine, Howard University Hospital, Washington, DC
  • Sheik Nasir Hassan Department of Internal Medicine, Howard University Hospital, Washington, DC
  • Reginald Chisholm Department of Clinical Oncology, Howard University Hospital, Washington, DC
  • Suguna Chirla Department of Pathology, Howard University Hospital, Washington, DC
  • Faisal Mukhtar Department of Radiation Oncology, Howard University Hospital, Washington, DC
  • Peter Sealy Department of Internal Medicine, Howard University Hospital, Washington, DC

DOI:

https://doi.org/10.5915/40-1-5285

Keywords:

Duodenum, Synovial sarcoma, Radiation, Cytogenetics

Abstract

DOI: http://dx.doi.org/10.5915/40-1-5285

Synovial sarcoma of the digestive tract is an extremely rare tumor. Only 12 cases were reported; none of these was in the gastroduodenal region. Radiation therapy is well known for its long-term carcinogenesis, especially of soft tissue sarcomas. Only four cases of radiation-associated synovial sarcoma have been reported. We report a case of primary gastroduodenal synovial sarcoma in a 54-year-old woman who was treated for Hodgkin’s lymphoma at age 35, using external radiation to the mantle field and the paraortic strip (including abdominal paraaortic nodes). She presented with epigastric pain and sensation of fullness, associated with loss of appetite and weight. An upper endoscopy showed a distal gastric mass extending to the post-pulpal duodenum; a tissue biopsy of the mass showed monophasic synovial sarcoma with positive epithelial membrane antigen (EMA). The diagnosis was confirmed when reverse transcriptase-polymerase chain reaction (RT-PCR) demonstrated the presence of a SYT-SSX fusion transcript. She underwent total duodenectomy and partial gastrectomy and gastrojejunostomy. After surgery she regained her appetite and started gaining weight. She has been symptom-free for 7 months after the surgery.

Downloads

Published

2008-02-01

Issue

Vol. 40 No. 1 (2008)

Section

Case Reports

License

Authors who publish with this journal agree to the following terms:

  1. Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.

  2. Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.

  3. Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access).