腹壁に発生した滑膜肉腫の1例

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  • A CASE REPORT OF SYNOVIAL SARCOMA OCURRING IN THE ABDOMINAL WALL

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We describe a case of synovial sarcoma arising in the abdominal wall, which is the second in this country, and only 17 cases have been reported in the overseas literature.<br>A 20-year-old man presented with a large, left upper quadrant mass of two years period. There was no history of weight loss or any symptoms. Physical examination was unremarkable with the exception of a palpable, flat, slightly tender mass, 13 cm in diameter, occupying the left upper quadrant. Routine laboratory tests revealed no abnormality. Chest radiograph was normal. Abdomen radiograph showed right-medial dislocation of the small intestine by a large soft tissue mass, which had faint calcification within itself. Abdominal angiograph did not reveal any feeding artery to the mass. Ultrasonograph showed a cystic structure of the mass with some debris and small cysts. Abdominal computed tomography revealed an intramural cyst-like tumor protruding the peritoneal cavity with calcification. Apossible malignancy could not be denied, and aparotomy was performed. It was found that a soft tissue mass was arising between the transversus abdominis and internal oblique muscles and partly invading the rectus abdominis muscle. The mass was covered with peritoneum and there was no invasion into the intraperitoneal organs. The tumor was resected en bloc with the peritoneum, transversalis fascia, transversus and internal oblique muscle. Histological examination revealed the typical features of synovial sarcoma which was the mixture of two cell types including epithelioid and fibrosarcoma-like structure.

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