A Case of Giant Primary Pleuropulmonary Synovial Sarcoma

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Author Info

Brittany C. Fields Vijayalakshmi Ananthanarayanan Wickii T. Vigneswaran

Corresponding Author

Wickii T. Vigneswaran
Department of Thoracic and Cardiovascular Surgery, Loyola University Health System, Maywood, Illinois, USA

A B S T R A C T

Synovial sarcomas represent an extremely rare subtype of an already rare group of malignancies, soft tissue sarcomas. Among these, primary pulmonary synovial sarcomas comprise an even smaller number, though they have become more frequently reported in the literature. This case report details a case of giant primary pulmonary synovial sarcoma in a 44-year-old male patient who presented with left-sided chest pain and shortness of breath and was found to have a large left-sided pleural effusion. No malignant cells were demonstrated on cytology of pleural fluid after thoracentesis; however, CT-guided needle biopsy of pleural nodules seen on imaging demonstrated pathologic features consistent with monophasic type synovial sarcoma. He was treated with neoadjuvant chemotherapy with minimal response; thus, he was referred for surgical management. A left extrapleural pneumonectomy with resection of the left hemi-diaphragm and Gore-Tex prosthetic reconstruction was performed. Imaging at six-month follow-up demonstrated a new nodule in the contralateral lung, suggestive of metastasis at that time and the patient later developed ascites at nine months, consistent with further intra-abdominal metastasis. Perhaps early diagnosis and aggressive multimodality therapy may have a place in the treatment of this aggressive disease.

Article Info

Article Type

Case Report

Publication history

Received: Tue 16, Jun 2020
Accepted: Mon 06, Jul 2020
Published: Thu 23, Jul 2020

Copyright

© 2023 Wickii T. Vigneswaran. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Hosting by Science Repository.
DOI: 10.31487/j.JSO.2020.04.01