Abstract
Primary mediastinal synovial sarcoma is a rare malignancy with only a few cases reported so far. A 56-year-old woman was admitted to our hospital for an investigation of a nodule in the left middle lung on chest radiography. Computed tomography revealed a mediastinal mass first described as a solitary fibrous tumor. The diagnosis of synovial sarcoma was established by computed tomography-guided percutaneous needle biopsy. Work up showed no metastasis to distant organs or contralateral pleural cavity. The mass was surgically resected; pathological and immunohistochemical analyses confirmed the diagnosis of a monophasic spindle cell synovial sarcoma probably originating from phrenic nerve. The patient received adjuvant chemotherapy and radiation and is free of recurrence after a follow up of 16 months.
Highlights
Soft tissue sarcomas (STS) are a heterogeneous group of neoplasms
Primary mediastinal synovial sarcoma is a rare malignancy with only a few cases reported so far
The mass was surgically resected; pathological and immunohistochemical analyses confirmed the diagnosis of a monophasic spindle cell synovial sarcoma probably originating from phrenic nerve
Summary
Soft tissue sarcomas (STS) are a heterogeneous group of neoplasms. They account for less than 1% of all adult malignancies [1]. It accounts for up to 10% of all histological types of soft tissue sarcomas [2], is unrelated to synovium and can occur in almost any part of the body Survival rates of this malignancy have been reported to range between few months and many years. Chest computed tomography (CT) showed a 3.0 × 5.0 cm intrathoracic tumor, which was surrounded by pneumatocele (Figures 2 and 3). This seemed most consistent by morphological criteria with an extrapulmonary, mediastinal benign solitary fibrous tumor. Chest computed tomography showed an 3 × 5 cm measuring intrathoracic tumor with broadly based contact to the pericardium, surrounded by pneumatocele It was identified as an extrapulmonary, mediastinal benign solitary fibrous tumor. The patient is currently free of recurrence after a follow-up of 16 months
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