Synovial sarcoma with extensive osteoid and bone formation. 1993

S Milchgrub, and L Ghandur-Mnaymneh, and H D Dorfman, and J Albores-Saavedra
Department of Pathology, University of Texas Southwestern Medical Center, Dallas 75235-9072.

Four cases of synovial sarcoma with extensive calcification and osteoid and bone formation are reported. Ages ranged from 21 to 38 years. Two tumors were located in the foot and two in the thigh. Because of a well-circumscribed, densely calcified soft tissue mass, radiologically three patients were thought to have a benign lesion. The fourth patient was thought to have a paraosteal osteosarcoma because of an accompanying bone defect. Tumor size varied from 4.0 to 9.0 cm. Histologically, three tumors were biphasic and one predominantly monophasic. All showed amorphous calcifications with extensive ossification sometimes in a ribbon-like pattern of osteoid, simulating osteosarcoma. The extensive bone formation with abundant osteoid deposition may lead to a misdiagnosis of osteosarcoma. It is important to recognize this variant of synovial sarcoma with ossification and bone formation and distinguish it from extraskeletal osteosarcoma because of the difference in clinical behavior and course. Although the most important point in the recognition of this variant of synovial sarcoma is its biphasic pattern, this may not be apparent in a small tissue sample. Points that aid in the diagnosis include the uniform nuclear appearance of both the epithelial and the spindle cells versus the pleomorphism of osteosarcoma and in some cases the presence of amorphous concretions in sheets and small calcospherites within spaces surrounded by flat or conspicuous epithelial cells. These cells are immunoreactive for cytokeratin and epithelial membrane antigen.

UI MeSH Term Description Entries
D008297 Male Males
D009999 Ossification, Heterotopic The development of bony substance in normally soft structures. Ossification, Pathologic,Ectopic Ossification,Heterotopic Ossification,Ossification, Ectopic,Ossification, Pathological,Pathologic Ossification,Pathological Ossification
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults
D012516 Osteosarcoma A sarcoma originating in bone-forming cells, affecting the ends of long bones. It is the most common and most malignant of sarcomas of the bones, and occurs chiefly among 10- to 25-year-old youths. (From Stedman, 25th ed) Sarcoma, Osteogenic,Osteogenic Sarcoma,Osteosarcoma Tumor,Osteogenic Sarcomas,Osteosarcoma Tumors,Osteosarcomas,Sarcomas, Osteogenic,Tumor, Osteosarcoma,Tumors, Osteosarcoma
D012983 Soft Tissue Neoplasms Neoplasms of whatever cell type or origin, occurring in the extraskeletal connective tissue framework of the body including the organs of locomotion and their various component structures, such as nerves, blood vessels, lymphatics, etc. Neoplasm, Soft Tissue,Neoplasms, Soft Tissue,Soft Tissue Neoplasm
D013194 Staining and Labeling The marking of biological material with a dye or other reagent for the purpose of identifying and quantitating components of tissues, cells or their extracts. Histological Labeling,Staining,Histological Labelings,Labeling and Staining,Labeling, Histological,Labelings, Histological,Stainings
D013584 Sarcoma, Synovial A malignant neoplasm arising from tenosynovial tissue of the joints and in synovial cells of tendons and bursae. The legs are the most common site, but the tumor can occur in the abdominal wall and other trunk muscles. There are two recognized types: the monophasic (characterized by sheaths of monotonous spindle cells) and the biphasic (characterized by slit-like spaces or clefts within the tumor, lined by cuboidal or tall columnar epithelial cells). These sarcomas occur most commonly in the second and fourth decades of life. (From Dorland, 27th ed; DeVita Jr et al., Cancer: Principles & Practice of Oncology, 3d ed, p1363) Synovioma,Sarcomas, Synovial,Synovial Sarcoma,Synovial Sarcomas,Synoviomas

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