Case Report: A Young Man With Giant Pericardial Synovial Sarcoma

Figures

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  Figure 1. Imaging data. (A) CT image taken during the first admission. (B) After pericardiocentesis, CT indicating a suspicious mass (red arrow). (C) Echocardiography showing pericardial space-occupying lesions. (D) Reexamination after 5 months showed obvious space occupation (red arrow). (E) Preoperative magnetic resonance imaging, right pericardium, showing a cystic mass (red arrow). (F) During the operation, the tumor filled the pericardial cavity. (G) Tumor recurrence noted 5 months after operation (red arrow).

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  Figure 2. Histopathological examination. (A) A small number of mesothelial cells and lymphocytes were found in the pleural effusion, but no malignant tumor cells were found. (B) Tissue cells, lymphocytes, and no malignant tumor cells could be found in the left pleural effusion. Mycobacterium tuberculosis was found to be negative by acid-fast staining (–). (C–E) Damaged tissue of pericardial tumor, which measured 20 × 17 × 5 cm, with some gelatinous areas. Mesenchymal tissue-derived tumors, with dense spindle cell areas and edema areas, combined with immunohistochemistry, do not rule out SS. Immunohistochemistry results: CK (–), EMA (focal +), TLEL (+), CD34 (–), S100 (–), CD99 (partial +), Bcl-2 (+), Ki67 (hot spot 25% +), WT-1 (–), Desmin (–), SMA (–), Vim (+), calponin (partial +), INI-1 (–), ERG (–), p53 (30% weak +), HMB45 (–), FLI-1 (–). (F) Fluorescence in situ hybridization (FISH) showing rearrangement of the SS18 gene, indicating positive result.