Unexpected diagnosis for an adrenal tumor: synovial sarcoma☆

published online 10 August 2009.

Abstract

A 39-year-old woman presented with an incidentally discovered mass of the left adrenal fossa. Computed tomography and magnetic resonance imaging did not show any other lesion. Histologically, this mass was composed of a dense proliferation of spindle cells with a fibrosarcomatous-like pattern. Immunohistochemistry using anticytokeratin showed some epithelial cells within the tumor. The diagnosis of primitive synovial sarcoma of the left adrenal fossa was confirmed by the presence of the characteristic t(X;18) translocation. Despite radiotherapy, several chemotherapies, and 2 other surgical resections, the patient died 30 months after the initial diagnosis. To our knowledge, this report constitutes the first described case of synovial sarcoma arising in the adrenal gland.

Keywords: Synovial sarcoma, Adrenal, Tumor, Immunohistochemistry

a Service d'Anatomie et de Cytologie Pathologiques, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris (APHP), 27 rue du Faubourg Saint-Jacques, 75679 Paris cedex 14, France

b Université Paris Descartes, 15 rue de l'Ecole de Médecine, 75270 Paris cedex 6, France

c Département Endocrinologie, Métabolisme et Cancer (Inserm U567 CNRS UMR8104, Institut Cochin, 22 rue Méchain, 75014 Paris, France

d Service de Radiologie A, Hôpital Cochin, APHP, 27 rue du Faubourg Saint-Jacques, 75679 Paris cedex 14, France

e Service de Chirurgie Générale, Hôpital Cochin, APHP, 27 rue du Faubourg Saint-Jacques, 75679 Paris cedex 14, France

f Unité de Génétique Somatique, Institut Curie, 26 rue d'Ulm, 75248 Paris cedex 05, France

g Unité d'Oncologie, Hôpital Cochin, APHP, 27 rue du Faubourg Saint-Jacques, 75679 Paris cedex 14, France

h Service d'Endocrinologie, Hôpital Cochin, APHP, 27 rue du Faubourg Saint-Jacques, 75679 Paris cedex 14, France

i Service d'anatomie pathologique, Hôpital Trousseau, CHRU de Tours, Université François Rabelais, Tours Cedex 9, France

Corresponding author. Service d'Anatomie Pathologique, Hôpital Cochin, 27 rue du Faubourg Saint-Jacques, 75679 Paris cedex 14, France. Tel.: +33 1 58 41 14 71; fax: +33 1 58 41 14 80.

☆ This case was presented (poster) in June 2008 at the French Congress of Pathology “Assises de Pathologie”, Nice, France.

1 P.A.J. and F.T. contributed equally to this work.

PII: S1092-9134(09)00058-6

doi:10.1016/j.anndiagpath.2009.05.004

13 of 15