Key result
Laparoscopic intragastric resection of a 10-mm gastric synovial sarcoma allowed for a full-thickness, margin-free excision, with the patient remaining alive and disease-free at 18 months.
Why the study?
Gastric synovial sarcoma is very uncommon and requires complete tumor excision, but laparoscopic intragastric resection had not previously been reported for this condition.
Case Report (n=1)
No
Laparoscopic intragastric resection is a feasible, minimally invasive, and organ-preserving approach for small gastric synovial sarcomas located near the esophagogastric junction.
Gastric SS case adds to sparse data; leaves open optimal resection strategy and prognosis in rare sites.
BACKGROUND: Synovial sarcoma (SS) is a rare soft tissue tumor. Among different anatomical locations where it can be found, gastric localization is a very uncommon one. Based on soft tissue sarcoma guidelines, complete tumor excision is considered the main treatment approach. Depending on size and localization of the tumor, both wedge and major gastric resections have been performed in the past for the treatment of this condition. CASE PRESENTATION: We present the case of a 43-year-old woman who underwent a laparoscopic intragastric excision of a gastric 10-mm SS located nearby the esophagogastric junction. Pathology examination confirmed the presence of a SS. The resected specimen confirmed margin-free excision of a monophasic spindle cell neoplasm invading the submucosa and presenting the rearrangement of SS18 gene at fluorescence in situ hybridization (FISH). No adjuvant treatment was offered, and 18 months after surgery, the patient was alive and disease free. CONCLUSIONS: This represents the first case reported in literature of a laparoscopic intragastric resection for a gastric SS. This approach allowed to obtain a full thickness radical tumor resection with the advantages of minimally invasive and organ preserving surgery.
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Rivelli et al. (2021) conducted a case report in Gastric synovial sarcoma (n=1). Laparoscopic intragastric resection was evaluated on Tumor resection and disease-free survival. Laparoscopic intragastric resection of a 10-mm gastric synovial sarcoma allowed for a full-thickness, margin-free excision, with the patient remaining alive and disease-free at 18 months.
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