Metastatic pulmonary synovial sarcoma: A double coincidence: Case report

Abstract

Synovial sarcomas are considered as one of the most aggressive neoplasms that account for approximately 8% of all soft tissue sarcomas; they are mainly localized in soft tissues of the extremities and joints and rarely occur in the thorax. In this case report, we describe a 34-year-old woman presenting a chest pain with a chest radiography showing a mass lesion occupying two-thirds of the right hemi-thorax. A malignant pulmonary tumor was suspected after CT imaging revealing a bilateral renal metastasis, and then a spindle-cell carcinoma was thought-about. The post-operative pathological analysis of the main mass confirmed the diagnosis of a pulmonary synovial sarcoma.

Keywords: Chest CT; Renal metastasis; Synovial sarcoma.

Fig. 1

(A) Chest X-ray showed a large lump in the right thoracic cavity. (White arrows). (B,C) Axial and coronal contrast-enhanced computed tomography scans of the chest in the mediastinal parenchyma window, revealing a 149mm pulmonary mass hypodense, heterogeneously enhanced and delimiting areas of necrosis with a clear mediastinal deviation. (D,E) Axial and coronal contrast-enhanced computed tomography scan of the abdomen; showed two renal metastasizes, hypodense and non-enhanced after the injection of the contrast medium suggesting secondary metastases. (Red arrows).