A surgical case of primary pulmonary synovial sarcoma confirmed by the detection of an SYT-SSX1 fusion gene

Abstract

We present a case of primary pulmonary synovial sarcoma in a 41-year-old female. A well-defined round nodule was pointed out in her right upper lobe on routine chest X-ray and computed tomography. Fluorodeoxyglucose positron emission tomography (FDG-PET) showed mild uptake with a maximum standardized uptake value of 2.5 at the lung nodule. No other abnormal FDG uptake was detected. As our preoperative diagnosis was benign lung tumor, we performed partial lung resection. However, the pathological diagnosis was a malignant tumor which consisted of spindle cells with very high mitotic activity. We suspected synovial sarcoma by the result of histological findings and immunohistochemical examination. Finally, an SYT-SSX1 fusion gene transcript was finally detected by reverse transcriptase polymerase chain reaction analysis. On the basis of these findings, we diagnosed primary pulmonary synovial sarcoma of monophasic fibrous type. Then completion right upper lobectomy was performed, she is alive and has been disease-free for 2 years.