Synovial Sarcoma of the Nerve-Clinical and Pathological Features: Case Series and Systematic Review

Stephen Shelby Burks, Ross C. Puffer, Iahn Cajigas, David Valdivia, Andrew E. Rosenberg, Robert J. Spinner, Allan D. Levi

Research output: Contribution to journalReview article

Abstract

BACKGROUND: Synovial sarcoma of the nerve is a rare entity with several cases and case series reported in the literature. Despite an improved understanding of the biology, the clinical course is difficult to predict. OBJECTIVE: To compile a series of patients with synovial sarcoma of the peripheral nerve (SSPN) and assess clinical and pathological factors and their contribution to survival and recurrence. METHODS: Cases from 2 institutions collected in patients undergoing surgical intervention for SSPN. Systematic review including PubMed and Scopus databases were searched for related articles published from 1970 to December 2018. Eligibility criteria: (1) case reports or case series reporting on SSPN, (2) clinical course and/or pathological features of the tumor reported, and (3) articles published in English. RESULTS: From patients treated at our institutions (13) the average follow-up period was 3.2 yr. Tumor recurrence was seen in 4 cases and death in 3. Systematic review of the literature yielded 44 additional cases with an average follow-up period of 3.6 yr. From pooled data, there were 10 recurrences and 7 deaths (20% and 14%, respectively). Adjuvant treatment used in 62.5% of cases. Immunohistochemical markers used in diagnosis varied widely; the most common are the following: Epithelial membrane antigen (EMA), cytokeratin, vimentin, cluster of differentiation (CD34), and transducin-like enhancer of split 1 (TLE1). Statistical analysis illustrated tumor size and use of chemotherapy to be negative predictors of survival. No other factors, clinically or from pathologist review, were correlated with recurrence or survival. CONCLUSION: By combining cases from our institution with historical data and performing statistical analysis we show correlation between tumor size and death.

Original languageEnglish (US)
Pages (from-to)E975-E991
JournalClinical Neurosurgery
Volume85
Issue number6
DOIs
StatePublished - Dec 1 2019

Keywords

  • Intraneural
  • Peripheral nerve
  • Plexus
  • SSPN
  • Synovial sarcoma

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

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