{"id":"2461f69b-48bb-4727-adda-4abc4059efe5","slug":"primary-intracranial-synovial-sarcoma-a-case-report-and-review-of-literature","title":"Primary intracranial synovial sarcoma: A case report and review of literature","authors":["Tarang K. Vora","Rahul Lath","Meenakshi Swain","Amitava Ray"],"abstract":"Background: Primary intracranial synovial sarcomas (PrISS) are unusual dural based mesenchymal tumors seen most commonly in the supratentorial compartment. They can mimic a spontaneous intracranial hemorrhage or a high-grade glioma on imaging. Case Description: A 31-year-old male presented with headache and right hemiparesis for 2 weeks. CT brain revealed a left frontal spontaneous intracerebral hemorrhage. PrISS revealed a heterogeneously ring enhancing solid cystic lesion with attachment to convexity dura. Intraoperatively, it mimicked a high-grade glioma. Histopathology report showed features of a synovial sarcoma, which was later confirmed with IHC. Classical SYT-SSX2 translocation was confirmed only on RTPCR after fluorescent in situ hybridization (FISH) was negative for same. Whole body positron emission tomography (PET-CT) did not show any extracranial tumor. Despite radiotherapy, there were recurrence and tumor progression at 6 months and the patient succumbed 11 months later. Conclusion: PrISS is an unusual aggressive intracranial neoplasm that carries a worse prognosis when compared nonintracranial synovial sarcomas. Molecular cytogenetics (FISH and RTPCR) are essential for confirming the diagnosis, though FISH seems to have a lower sensitivity and can yield false negative results as was noted in this case.","thumbnailUrl":"https://sni-digital-videos.s3.amazonaws.com/articles/2461f69b-48bb-4727-adda-4abc4059efe5/featured/hero-1781560905978.png","publishDate":"2022-09-30T00:00:00.000Z","doi":"10.25259/SNI_665_2022","categories":["Neuro-oncology","Case Report"],"fullTextUrl":"https://surgicalneurologyint.com/wp-content/uploads/2022/09/11903/SNI-13-447.pdf"}