Rare Lung Cancer

Abstract

58 year old male with seasonal asthma and no family history. Presents for evaluation of incidental finding of lung nodule on computed tomography scan (CT scan). His prior work exposure includes a history as mechanic and some asbestos exposure. History of a positive PPD that was not treated. No symptoms. Lifelong non-smoker. He had a CT chest in 2018, which had no parenchymal findings. He presented to ER 7/2019 with abdominal pain and was found new mass in right lower lobe. He was sent for positron emission tomography (PET scan) CT scan, which found a minimally active, 4cm mass in right lower lobe with no adenopathy, no other abnormalities on either PET or CT were found. Patient was sent for right video assisted thoracoscopic surgery (VATS) with wedge resection and partial diaphragm removal. Pathology showed rearrangement involving the SS18 gene region and a diagnosis of biphasic synovial sarcoma was made. Referred to oncology and therapy and treatment is pending. Sarcomas are a rare group of malignant tumors, and make up less than 1% of all adult malignancies and 12% of pediatric malignancies. The overall prognosis is relatively poor. Approximately 80% of sarcomas originate in the soft tissue, and the rest originate in the bone. In nearly all instances, they are thought to arise de novo, and not from a preexisting benign lesion.