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Case Study of Primary Synovial Sarcoma in a 50-Year-Old Male with Prostatic Symptoms

This case presents a 50-year-old male experiencing prostatic symptomatology, with normal PSA serum levels and an enlarged, homogeneous prostate. Ultrasound revealed no focal changes. A needle biopsy provided 12 representative samples, which were evaluated through immunohistochemistry. Findings included positive EMA, AE1-AE3, and slight vimentin, while PSAs and PAPH were negative. FISH analysis indicated a SYT-SSX fusion, confirming primary synovial sarcoma of the prostate. The study emphasizes differential diagnostics for leiomyosarcoma, sarcomatoid TCC, and phylloid tumor.

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Case Study of Primary Synovial Sarcoma in a 50-Year-Old Male with Prostatic Symptoms

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Presentation Transcript

  1. Case 9

  2. Clinical data • 50-year-old male with prostatic symptomatology • PSA serum level-normal • Homogenous, enlarged soft prostate • No focal changes were revealed ultrasonographically • Needle biospy: 12 reprezentative samples 11-21 mm

  3. ???

  4. Striped Basilisc Basiliscus vittatus

  5. Immunohistochemistry • EMA, AE1-AE3, vimentin-slightly positive • Negative PSA, PAPH, CD 99

  6. fusion SYT-SSX-positive FISH (event. RT-PCR)

  7. Primary synovial sarcoma of the prostate

  8. Synovial sarcoma • Synovial sarcoma is characterised by specific translocation t(X;18), resulting fusion of gene SYT (18q11) and related genes SSX1 (Xp11.23), resp. SSX2 (Xp11.21). • SYT-SSX1 for bifasic SS • SYT-SSX2 for monophasis SS

  9. Diferential diagnostics • Leiomyosarcoma of the prostate/ leiomyoma • Postoperative spindle cell nodulus • Sarcomatoid TCC • Phylloid tumor of the prostate

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