Renal Synovial Sarcoma in a Young Pregnant Lady: A Case Report and Clinico-Pathological Profile
Published: July 1, 2017 | DOI: https://doi.org/10.7860/JCDR/2017/25733.10245
Gregory Pathrose, Nirmal Thampi John, Pradeep Hariharan
1. Assistant Professor, Department of Urology, Mar Baselious Medical Mission, Ernakulam, Kerala, India.
2. Professor, Department of Urology, Christian Medical College, Vellore, Tamil Nadu, India.
3. Assistant Professor, Department of Pathology, Christian Medical College, Vellore, Tamil Nadu, India.
Correspondence
Dr. Nirmal Thampi John,
Professor, Department of Urology, Christian Medical College, Vellore-632002, Tamil Nadu, India
E-mail : nirmaltj@gmail.com
Synovial sarcoma is a soft tissue neoplasm with clearly defined histologic, immunohistochemical and molecular features. These tumours usually arise in the extremities of young adults. Their occurrence in the kidney is extremely rare. A 25-year-old pregnant lady in her first trimester was incidentally found to have a left renal mass on perinatal ultrasonography. MRI showed a well encapsulated, heterointense mass replacing the left kidney. Following medical termination of her pregnancy, a radical nephrectomy was performed. Histopathology revealed a primary synovial cell sarcoma of the kidney. Postoperatively, she received ifosfamide based adjuvant chemotherapy. This report highlights the challenges involved in the diagnosis of this extremely rare neoplasm. A high index of clinical suspicion, complimented by the use of immunohistochemistry and cytogenetics during histopathological analysis aide in the diagnosis. Aggressive management with a combination of complete surgical extirpation and chemotherapy gives the best results.
[
FULL TEXT ] | [ PDF]