Primary synovial sarcoma of kidney: a rare case report with review of literature

Abstract
Background
Synovial sarcoma is a rare type of sarcoma with a predilection for extremities in young adults. Very rarely this tumor can originate from kidney.

Case presentation
A 22-year-old female presented to us with complaints of right flank pain and a large mass in the right side of abdomen for the last 6 months. A provisional diagnosis of renal cell carcinoma was made and right radical nephrectomy was done. However on histopathological examination the tumor was composed of spindle cells arranged in hemangiopericytoma-like vascular pattern. Immunohistochemistry and FISH confirmed the diagnosis of synovial sarcoma of kidney. The patient had no signs of recurrence or metastasis at six months of follow-up.

Conclusion
Renal synovial sarcomas, though rare, should be considered as a differential in young adults who present with extremely large renal mass. Surgical extirpation is the treatment of choice. Ifosfamide- and doxorubicin-based chemotherapy can be given in non resectable and metastatic cases.