Abstract
A 30-year-old man presented with a witnessed seizure and loss of consciousness. An MR image of the brain showed multiple embolic infarcts and a 2 dimensional echocardiogram showed a large mitral-valve mass (figure a). The patient underwent open-heart surgery to remove what was thought to be a myxoma. However, a pathological examination of the removed tissue identified a biphasic synovial sarcoma (figure b). This was confirmed by identification of a chromosomal translocation, t(X;18), that associates with more than 90% of all synovial sarcomas.
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