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Abstract
Case summary
A 55-year-old male visited our clinic with a 2-month history of decreased visual field in the left eye. The best corrected visual acuity of the left eye was 1.0, and 2.5 mm of proptosis was observed. There was slight limitations in motility and a mild visual field defect in the inferotemporal quadrant of the left eye. Funduscopic examination of the left eye revealed papilledema. Orbital magnetic resonance imaging (MRI) demonstrated the presence of an orbital mass that extended inferotemporally into the left orbit. On magnetic resonance imaging, a well-demarcated and 2.7 × 2.0 × 2.2 cm sized tumor was identified with intermediate signal intensities on T1/T2-weighted scans with slight homogenous enhancement. We approached the orbital mass using a lateral conjunctival incision with left canthotomy and cantholysis and performed partial surgical resection of the mass because the mass encircled the optic nerve. The mass was diagnosed as synovial sarcoma based on the findings of both histopathology and immunohistochemical staining. Postoperatively, the patient underwent radiation therapy to the rest of the tumor site.
Figures and Tables
Figure 1
Magnetic Resonance Imaging of the left orbit demonstrates a large, homogenous, well-circumscribed mass in the retrobulbar space. The mass abuts onto the optic nerve and compresses it superomedially. Axial (A) and coronal (B) views.
Figure 2
Higher magnification of the biphasic synovial sarcoma specimen (hematoxylin & eosin stain [H&E]; original magnification, ×400). The spindle cell component is elongated cells with spindled hyperchromatic nuclei and scant amounts of cytoplasm. The epithelioid cell component shows cuboidal to round cells with oval to round nuclei, abundant cytoplasm, and prominent nucleoli.
Figure 3
Higher magnification of the biphasic synovial sarcoma specimen (immunohistochemical stain; original magnification, ×200). (A) Vimentin immunohistochemical staining of the tissue shows diffuse and dense positivity in the spindle cell component. (B) Epithelial membrane antigen (EMA) immunohistochemical staining highlights the epithelial component of this biphasic synovial sarcoma.
References
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