Ann Thorac Oncol Res | Volume 3, Issue 1 | Research Article | Open Access

Clinical and Pathologic Biomarkers of Metastases in Primary Thoracic Synovial Sarcoma

Paul H Hartel1,2* and John E Parker2

1Department of Pathology, Sligo University Hospital, Ireland
2Department of Medicine, West Virginia University School of Medicine, USA

*Correspondance to: Paul H Hartel 

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Limited research surrounding potential biomarkers in synovial sarcoma exists, with inconclusive results pertaining to prognostic utility of SS18/SSX fusion types. We evaluated clinical and pathologic parameters in 8 cases of metastatic primary thoracic synovial sarcoma and compared our results with published cases without metastases in an effort to identify clinical and/or pathologic biomarkers of metastatic disease. Patients were 4 males and 4 females, aged 10 to 73 years (mean, 42) with metastatic primary thoracic synovial sarcoma. Primary tumors were in lung (5), pleura (2) and mediastinum (1). Treatment was complete excision. None had adjuvant treatment. Five patients had local recurrence. Metastases were to regional lymph nodes (5), bilateral lungs (1), liver (1), and spleen (1). Histological features were those seen with usual pulmonary and soft tissue synovial sarcoma including monophasic (5) and biphasic (3) tumors with dense cellularity, interlacing fascicles, and hyalinized stroma. Five of 8 cases showed unusual histology of papillary formations (1), Verocay bodies (1), rhabdoid morphology (1), and adenomatoid foci (1). The chromosomal translocation t(x;18) was present in 6 cases with available tissue where 3 were fusion type SS18/SSX1 and 3 were fusion type SS18/SSX2. In contrast to published rates in primary thoracic synovial sarcoma cases without metastases, a higher proportion of our metastatic thoracic synovial sarcoma cases showed local recurrence of disease (63% vs. 28%), and histology unusual for synovial sarcoma (50% vs. 20%). These variables may therefore represent clinical and histologic biomarkers of metastatic disease, and may be useful in early targeting of select patients for adjuvant treatment.


Synovial sarcoma; Pulmonary sarcoma; Metastatic sarcoma; Biomarkers


Hartel PH, Parker JE. Clinical and Pathologic Biomarkers of Metastases in Primary Thoracic Synovial Sarcoma. Ann Thorac Oncol Res. 2022; 2(1): 1013..

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