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International Journal of Surgery Case... Jul 2024Synovial sarcoma is a relatively common high-grade soft-tissue sarcoma. This lesion accounts for 5-10 % of soft-tissue sarcomas, which tend to appear in the limbs,...
INTRODUCTION
Synovial sarcoma is a relatively common high-grade soft-tissue sarcoma. This lesion accounts for 5-10 % of soft-tissue sarcomas, which tend to appear in the limbs, especially the lower limbs. Synovial sarcoma in the neck is rare and causes involvement of the head and neck in 6-7 % of cases. Intraosseous involvement of the mandible is rare. In this report, a rare intraosseous synovial sarcoma of the mandible is reported.
PRESENTATION OF CASE
A 29-year-old man with a complaint of painless outgrowth of the gingiva in the posterior region of the left mandible. In the intraoral examination, an exophytic, firm, smooth and well-defined lobulated mass on the alveolar ridge, extending from distal of the second premolar to mesial of the second molar, was observed. On a radiographic examination, a radiolucent lesion with an ill-defined border was seen in the left body of the mandibular with perforation of the buccal cortex. In a histological examination, immunohistochemistry confirmed synovial sarcoma. The patient underwent surgery with wide margins, and radiotherapy after surgery.
DISCUSSION
The main treatment method is surgery with a wide margin. Radiotherapy as an adjuvant treatment along with surgery is the second most common treatment method. Radiotherapy is recommended in cases of involvement of the margin of the lesion, size greater than 5 cm, and recurrence of the lesion. Chemotherapy after surgery has been used less frequently.
CONCLUSION
Surgical resection with a wide margin is the main treatment. Adjuvant radiation therapy and chemotherapy can be helpful in tumor control, especially in monophasic cases.
PubMed: 38870657
DOI: 10.1016/j.ijscr.2024.109880 -
Autoimmunity Dec 2024Rheumatoid arthritis (RA) is the predominant manifestation of inflammatory arthritis, distinguished by an increasing burden of morbidity and mortality. The intricate...
Rheumatoid arthritis (RA) is the predominant manifestation of inflammatory arthritis, distinguished by an increasing burden of morbidity and mortality. The intricate interplay of genes and signalling pathways involved in synovial inflammation in patients with RA remains inadequately comprehended. This study aimed to ascertain the role of necroptosis in RA, as along with their associations with immune cell infiltration. Differential expression analysis and weighted gene co-expression network analysis (WGCNA) were employed to identify central genes for RA. In this study, identified total of 28 differentially expressed genes (DEGs) were identified in RA. Utilising WGCNA, two co-expression modules were generated, with one module demonstrating the strongest correlation with RA. Through the integration of differential gene expression analysis, a total of 5 intersecting genes were discovered. These 5 hub genes, namely fused in sarcoma (FUS), transformer 2 beta homolog (TRA2B), eukaryotic translation elongation factor 2 (EEF2), cleavage and polyadenylation specific factor 6 (CPSF6) and signal transducer and activator of transcription 3 (STAT3) were found to possess significant diagnostic value as determined by receiver operating characteristic (ROC) curve analysis. The close association between the concentrations of various immune cells is anticipated to contribute to the diagnosis and treatment of RA. Furthermore, the infiltration of immune cells mentioned earlier is likely to exert a substantial influence on the initiation of this disease.
Topics: Arthritis, Rheumatoid; Humans; Necroptosis; Gene Regulatory Networks; Gene Expression Profiling; Transcriptome; Computational Biology; Gene Expression Regulation; Signal Transduction; STAT3 Transcription Factor; Biomarkers; ROC Curve
PubMed: 38869013
DOI: 10.1080/08916934.2024.2358069 -
Clinical Case Reports Jun 2024Extensive studies are required to understand the behavior as well as prognosis of SS in the colorectal region. IHC staining is essential for the accurate diagnosis when...
Extensive studies are required to understand the behavior as well as prognosis of SS in the colorectal region. IHC staining is essential for the accurate diagnosis when a lesion is encountered at an unusual site.
PubMed: 38868121
DOI: 10.1002/ccr3.9062 -
Cureus May 2024Synovial sarcoma is a high-grade sarcoma. The periarticular region, deep soft tissues, and the extremities are where it is most frequently found. The head and neck...
Synovial sarcoma is a high-grade sarcoma. The periarticular region, deep soft tissues, and the extremities are where it is most frequently found. The head and neck regions are rarely affected and salivary gland localization is rather rare, especially the submaxillary gland. The process of diagnosis and therapeutic management remains challenging, particularly in cases with uncommon tumor locations where the establishment of a universal therapeutic consensus is complicated. Early diagnosis and a multidisciplinary approach can lead to success without locoregional recurrence or distant metastases.
PubMed: 38854186
DOI: 10.7759/cureus.59932 -
Asian Journal of Surgery Jun 2024
PubMed: 38853112
DOI: 10.1016/j.asjsur.2024.05.211 -
Transcriptional regulation and therapeutic potential of cyclin-dependent kinase 9 (CDK9) in sarcoma.Biochemical Pharmacology Jun 2024Sarcomas include various subtypes comprising two significant groups - soft tissue and bone sarcomas. Although the survival rate for some sarcoma subtypes has improved... (Review)
Review
Sarcomas include various subtypes comprising two significant groups - soft tissue and bone sarcomas. Although the survival rate for some sarcoma subtypes has improved over time, the current methods of treatment remain efficaciously limited, as recurrent, and metastatic diseases remain a major obstacle. There is a need for better options and therapeutic strategies in treating sarcoma. Cyclin dependent kinase 9 (CDK9) is a transcriptional kinase and has emerged as a promising target for treating various cancers. The aberrant expression and activation of CDK9 have been observed in several sarcoma subtypes, including rhabdomyosarcoma, synovial sarcoma, osteosarcoma, Ewing sarcoma, and chordoma. Enhanced CDK9 expression has also been correlated with poorer prognosis in sarcoma patients. As a master regulator of transcription, CDK9 promotes transcription elongation by phosphorylation and releasing RNA polymerase II (RNAPII) from its promoter proximal pause. Release of RNAPII from this pause induces transcription of critical genes in the tumor cell. Overexpression and activation of CDK9 have been observed to lead to the expression of oncogenes, including MYC and MCL-1, that aid sarcoma development and progression. Inhibition of CDK9 in sarcoma has been proven to reduce these oncogenes' expression and decrease proliferation and growth in different sarcoma cells. Currently, there are several CDK9 inhibitors in preclinical and clinical investigations. This review aims to highlight the recent discovery and results on the transcriptional role and therapeutic potential of CDK9 in sarcoma.
PubMed: 38848777
DOI: 10.1016/j.bcp.2024.116342 -
Pediatrics Jul 2024A 15-year-old patient with metastatic synovial sarcoma conveyed to his palliative care physician that his dying wish was to start gender-affirming hormone therapy. His...
A 15-year-old patient with metastatic synovial sarcoma conveyed to his palliative care physician that his dying wish was to start gender-affirming hormone therapy. His medical team was able to identify resources to support both him and his family as they navigated the immense difficulty of a cancer diagnosis and began to understand their child's gender identity. Literature on the care of gender diverse pediatric patients with terminal illness is minimal, but applications from adult literature, and research on supporting gender diverse adolescents more broadly, provided guidance for palliative care, oncology, and gender-affirming care teams. We believe that honoring and supporting the gender identity of adolescents with terminal illness is an essential aspect of end-of-life care. This case report outlines challenges faced by multidisciplinary pediatric team members who provided gender-affirming care for a minor under hospice care and amplifies the need for future research and guidelines pertinent to this patient population.
Topics: Humans; Adolescent; Palliative Care; Transgender Persons; Male; Female; Hospice Care
PubMed: 38845556
DOI: 10.1542/peds.2023-064830 -
Veterinary Research Communications Jun 2024A 12-year-old, 3 kg spayed female mixed-breed dog was evaluated to assess a 1-year history of intermittent right forelimb lameness that did not have adequate response...
A 12-year-old, 3 kg spayed female mixed-breed dog was evaluated to assess a 1-year history of intermittent right forelimb lameness that did not have adequate response to nonsteroidal anti-inflammatory drugs. The radiographic study performed under sedation showed multifocal radiolucent areas affecting both the right humerus and scapula with focal soft tissue swelling; a CT scan confirmed the existence of an aggressive and invasive soft tissue mass affecting the scapulohumeral joint. Fine needle aspiration results suggested a low-grade synovial sarcoma and therefore a scapulectomy was performed. The biopsy showed spindle to stellated cells immersed in a basophilic and mucinous (myxoid) matrix with mild to moderate anisocytosis, moderate anisokaryosis, some binucleated cells and sporadic multinucleated cells. These findings are consistent with low-grade synovial myxosarcoma, a not well described synovial neoplasm that can mimic other commonly seen joint tumors or even septic arthritis on radiographs. The purpose of this case report is to describe the first reported synovial myxosarcoma affecting the scapulohumeral joint of a small dog.
PubMed: 38833194
DOI: 10.1007/s11259-024-10430-z -
Journal of Surgical Case Reports Jun 2024A 52-year-old gentleman presented with symptoms of breathlessness and type 1 respiratory failure. His CT pulmonary angiogram showed a heterogenous, oval-shaped lesion...
A 52-year-old gentleman presented with symptoms of breathlessness and type 1 respiratory failure. His CT pulmonary angiogram showed a heterogenous, oval-shaped lesion between the heart and diaphragm with a right atrial (RA) filling defect, pericardial thickening and pulmonary metastasis. An RA debulking salvage operation confirmed this to be a pericardial tumour and further cytology and immunohistochemistry testing confirmed a primary synovial sarcoma. After 12 days in intensive care for ventilation, the patient was successfully discharged on warfarin and underwent oncology follow-up for chemotherapy. Following a 15-month follow-up, no mortality was observed despite the aggressive nature of the tumour.
PubMed: 38832058
DOI: 10.1093/jscr/rjae372