Abstract
We experienced a case of aggressive retroperitoneal synovial sarcoma. A 59-year-old man who had been suffering from occasional abdominal pain for several years visited our hospital because the pain became severe. Abdominal CT scan showed a hemorrhagic polycystic tumor 15cm in size in the left subphrenic space. Laparotomy findings showed hemorrhagic ascites and a slightly fragile retroperitoneal tumor, and tumor resection was performed. Pathological and genetic findings revealed primary retroperitoneal synovial sarcoma. During the follow-up period, extensive tumor recurrence was observed and palliative reduction surgeries were done four times, however, the patient died 20 months after the first surgery.
Primary retroperitoneal synovial sarcoma is an extremely rare tumor and carries poor prognosis. Complete surgical resection is the treatment of choice, however, the retroperitoneum has a large space and allows primary tumors to grow silently before its presentation. Thus, strategies for synovial sarcoma have yet to be established, and so we need to select optimal strategies for selected cases.
