Infiltrating Cardiac Synovial Sarcoma Presenting as Acute Cerebrovascular Accident

Abstract

Primary cardiac sarcoma is a rare malignant myocardial neoplasm that does not exhibit gender predominance or age predilection. The classification of these tumors includes several subtypes, of which synovial sarcoma is a rare manifestation. When present, these tumors portend a poor prognosis with high morbidity and mortality that is attributable to their inherent infiltrative capacity, especially in the absence of treatment. The general consensus for treatment is surgical excision and neoadjuvant chemotherapy and radiotherapy. In this report, a case of synovial sarcoma involving the left ventricular outflow tract and aortic valve is presented.

Monophasic Synovial Sarcoma of the Left Ventricle of the Heart: An Extremely Rare Case and Literature Review

“…The symptoms are usually caused by a local obstruction or functional interference, which clinically can present as dyspnea, chest pain, congestive heart failure, and syncope [8]. The sarcoma may cause emboli to the cerebral vasa and present as a cerebrovascular accident [6], [9]. In this case, the SS had originated from the LV and obstructed the LVOT; thus, it manifested as syncope in this patient.…”

“…Predicted prognosis based on age is challenging to conclude because of the wide variation of age and few cases reported. Cardiac SS patients involving the left side of the heart are extremely rare; there are only three cases reported of primary SS of the LV [5], [6], [7].…”

Primary cardiac atrial sarcomas. Report of two histologically different cases and review of the literature

“…The role of immunohistochemical studies in the differential diagnosis of synovial sarcoma is limited, so the detection of t(X;18)(p11.2;q11.2) translocation resulting in fusion of SYT with SSX1, 2 or 4 present in 90% of SS cases is a hallmark in diagnosis of this malignancy [50,73]. The diagnosis is based on FISH, but this genetic abnormality can also be detected with reverse transcription polymerase chain reaction (RT-PCT) next generation sequencing (NGS) [20,72].…”