Laparoscopic-endoscopic cooperative surgery achieves R0 resection in gastric synovial sarcoma with no recurrence at nine months

Synovial sarcoma is a malignant mesenchymal tumor, accounting for approximately 5–10% of all soft tissue sarcomas. To date, only 52 cases of primary gastric synovial sarcoma have been reported in the English-language literature. We report a rare case of primary gastric synovial sarcoma in a young woman. To the best of our knowledge, this is the second case in the past decade treated using combined laparoscopic and endoscopic surgery, and the first such case reported in China using this approach. A 37-year-old woman was admitted with a 9-month history of abdominal pain and a 3-month history of a gastric body tumor. Initial biopsy at an outside hospital suggested a spindle cell tumor. Immunohistochemistry and molecular testing confirmed gastric monophasic synovial sarcoma. The patient was transferred to our hospital for surgical treatment and underwent regular postoperative follow-up. After nine postoperative months, endoscopic examination revealed no local recurrence. No regional lymph node involvement or distant metastases were identified. The patient remained asymptomatic with good performance status and no gastrointestinal symptoms. Laparoscopic-endoscopic cooperative surgery is a feasible and effective minimally invasive approach for achieving complete (R0) resection of gastric synovial sarcoma while avoiding open surgery and its associated morbidity.