Cutaneous synovial sarcoma. A case report and a review of the literature

A case of Synovial Sarcoma (ss) occurred on the sural area of the left leg in a 86 years old woman is described. Its interest is due to the late onset, the primitively cutaneous localization and the rarity in dermatological literature. The SS is a mesenchymal malignant neoplasm composed typically of two different cell lines; spindle and epithelioid cells, whose ratio vary in different case. The commonest variant has both cell types and it is defined biphasic. The monophasic variant recognize only a cell type. Immunohistochemical studies point out the bipolar disposition since the cells have a distinct labelling patterns. The chromosomic translation t(X:18) (p11;q11) is present in the majority (80%) of the SS. Its two forms, the SYT-SS1 (X p 11,23) and SYT2-SS2 (X p 11,21) correspond respectively to biphasic and monophasic variants and stress the typical dualistic tendency of this neoplasm. The therapeutical approach must be aggressive. Radical surgical treatment associated to chemo and radiotherapy schedules has to be performed because of the tumor high malignancy. The prognosis depends on various factors such as age, dimensions, euploidy, number of mitoses and cell proliferation antigen presence.