Unusual Location of Synovial Sarcoma of the Abdominal Wall: About a Case and Review of the Literature

Abstract

Synovial sarcoma is a primary malignant mesenchymal tumor first described in 1893, which accounts for 2.5 – 10.5% of all primary soft tissue cancers. Abdominal synovialosarcoma is a rare and aggressive tumor that presents diagnostic and treatment challenges, as well as a difficult to predict prognosis. In this work we present the case of a 38-year-old patient who underwent surgery due to a cystic tumor of the left anterior abdominal wall. Medical imaging, particularly abdominal CT, revealed tissue heterogeneity which leads to compression of the rectus abdominis muscle as well as the left external oblique muscle. A large single-piece surgical resection of the tumor was performed on the patient. A biphasic synovialosarcoma of the abdominal wall was confirmed by pathological examination. Adjuvant chemotherapy was administered to the patient and after approximately 2 years he developed a recurrence of his disease which required appropriate management. It is important to discuss synovialosarcoma of the abdominal wall because of its rarity and the nonspecificity of its clinical symptoms. Its precise cause remains unknown; However, some studies suggest that particular genetic mutations may contribute to the development of this tumor. Its therapy is mainly based on surgery with adjuvant chemotherapy and/or radiotherapy which can improve the prognosis.