Synovial sarcoma presenting with huge mediastinal mass: a case report and review of literature

Abstract

BackgroundSynovial sarcoma presenting in the mediastinum is exceedingly rare. Furthermore, data addressing optimal therapy is limited. Herein we present a case where an attempt to downsize the tumor to a resectable state with chemotherapy was employed.Case presentationA 32 year female presented with massive pericardial effusion and unresectable huge mediastinal mass. Computed axial tomography scan - guided biopsy with adjunctive immunostains and molecular studies confirmed a diagnosis of synovial sarcoma. Following three cycles of combination Ifosfamide and doxorubicin chemotherapy, no response was demonstrated. The patient refused further therapy and had progression of her disease 4 months following the last cycle.ConclusionSynovial sarcoma presenting with unresectable mediastinal mass carry a poor prognosis. Up to the best of our knowledge there are only four previous reports where primary chemotherapy was employed, unfortunately; none of these cases had subsequent complete surgical resection. Identification of the best treatment strategy for patients with unresectable disease is warranted. Our case can be of benefit to medical oncologists and thoracic surgeons who might be faced with this unique and exceedingly rare clinical scenario.

A Patient with Primary Pericardial Synovial Sarcoma who Presented with Cardiac Tamponade: A Case Report and Review of the Literature

“…Soft tissue sarcoma is a rare malignancy, comprising less than 1% of malignant neoplasms; this proportion may be much less (<0.01%) in the thorax (6). In a previous study, synovial sarcoma was reported to account for 5% of 12,370 primary soft tissue sarcomas (7).…”

Giant primary synovial sarcoma of the anterior mediastinum: A case report and review of literature

“…Complete tumor resection is the only therapy associated with long-term survival with uncertainty existing regarding the best therapeutic strategy for patients with unresectable disease. [2] External beam radiotherapy and chemotherapy are other therapeutic options that have been used as primary therapy mostly in an attempt to reduce the tumor size to achieve resectability. [2] Therapeutic combinations of surgery, chemotherapy, and radiotherapy have been used in the management of this neoplasm.…”

“…[2] External beam radiotherapy and chemotherapy are other therapeutic options that have been used as primary therapy mostly in an attempt to reduce the tumor size to achieve resectability. [2] Therapeutic combinations of surgery, chemotherapy, and radiotherapy have been used in the management of this neoplasm. Here, we report a case of this rare tumor and review the relevant literature.…”

Initially Localized Synovial Sarcoma in Adults: A Retrospective Single-Center Analysis of 26 Patients Registered at the Department of Oncology, University of Vienna between 2004 and 2013

“…Adjuvant chemotherapy was administered to 12 adult patients (13.8%) and had no impact on survival [16]. Only few reports (case reports of adult patients with initially localized as well as initially metastatic SS) exist considering OS [19,20,21,22,23]. …”