Patient with 2-month history of lower back pain diagnosed with cancer of the thoracic vertebra.
This article describes the case of a 44-year-old male patient diagnosed with monophasic synovial sarcoma of thoracic vertebra. The patient presented to the hospital with a 2-month history of lower back pain radiating to both groins. The patient’s past medical history was insignificant.
On examination, the patient’s blood pressure was 120/70 mm Hg, pulse 82, respiratory rate 18 breaths/minute and temperature 98.9°F. Physical examination and further lab work did not show any significant findings. Further investigation including a CT scan of the chest confirmed the presence of multiple bilateral pulmonary nodules. In addition, presence of mediastinal and hilar lymphadenopathy. Doctors advised a CT-guided biopsy of the pulmonary nodule. CT findings showed a malignant neoplasm with spindle cells.
Immunohistochemical stains showed tumour cells positive for TLE-1, CD99, CD56, EMA, vimentin and BLC2. Whereas negative for synaptophysin, desmin, S100, cytokeratin, P63, CD10 and CD34. In addition, interphase FISH was consistent with the diagnosis of monophasic synovial sarcoma.
Synovial sarcoma is a rare tumour of the soft tissue that accounts for only 5% soft tissue sarcomas. The sarcoma is more common in the deep tissues extremities and is rarely seen in the axial skeleton. In addition, it affects young adults and has a male predominance. The disease has poor prognosis and a survival rate of less than 2% over 5 years.
The sarcoma is often metastatic at the time of presentation, such as in this case. Surgery with adjunct therapy is the primary therapeutic approach. However, survival rates are very low. This patient was referred to a different facility for further management.
A Rare Case of Monophasic Synovial Sarcoma of Thoracic Vertebra https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6276405/