Surgical treatment of primary synovial lung sarcoma: a case report

Abstract

Synovial sarcoma is a rare aggressive malignant mesenchymal tumor that accounts for 2.5–10.0% of all sarcomas and is most often found in the soft tissues of the extremities, especially near large joints. Primary synovial lung sarcoma is quite rare and accounts for 0.5% of all primary malignant lung neoplasms. The tumor is sensitive to chemotherapy, but the main method of treatment of synovial lung sarcoma remains surgical. Publications devoted to this topic, are presented by clinical observations due to the rare occurrence of the disease, therefore, each such observation is of scientific and practical interest.

We present a clinical case 65-year-old patient with a tumor of the right lung with a diameter of more than 25 cm. Repeated attempts to perform transthoracic puncture both in our department and in other hospitals for the biopsy were unsuccessful. Taking into account the progression of the disease, the appearance and increase of the respiratory failure clinic, the impossibility to exclude the malignant nature of the process and the good functional status of the patient, a decision for surgery was made. The patient underwent right pneumonectomy with mediastinal lymph node dissection. The postoperative period was complicated by intrapleural bleeding, for which a rethoracotomy was performed. After recovery, the patient was discharged from the hospital in a stable condition.

Keywords

primary synovial sarcoma of the lung / primary malignant mesenchymal lung tumor / surgical treatment of lung sarcoma

References

[1] Telugu RB, Kodiatte TA, Sakthi D, et al. Primary pulmonary synovial sarcoma: a clinicopathological study of 22 cases. Malays J Pathol. 2022;44(2):215–224.

[2] Telugu R.B., Kodiatte T.A., Sakthi D., et al. Primary pulmonary synovial sarcoma: a clinicopathological study of 22 cases // Malays J Pathol. 2022. Vol. 44, N 2. P. 215–224.

[3] Khestanov DB, Senzhapova ER, Romantsova OM, et al. The treatment of children with synovial sarcoma. Bone and Soft Tissue Sarcomas, Tumors of the Skin. 2016;(3):60–66. (In Russ).

[4] Хестанов Д.Б., Сенжапова Э.Р., Романцова О.М., и др. Лечение синовиальной саркомы у пациентов детского возраста // Cаркомы костей, мягких тканей и опухоли кожи. 2016. № 3. С. 60–66.

[5] Devleena, Bansal V, Chaudhuri T, Roy S. Primary synovial sarcoma of lung. Lung India. 2014;31(3):277–279. doi: 10.4103/0970-2113.135777

[6] Devleena, Bansal V., Chaudhuri T., Roy S. Primary synovial sarcoma of lung // Lung India. 2014. Vol. 31, N 3. P. 277–279. doi: 10.4103/0970-2113.135777

[7] Pandey L, Joseph D, Pasricha R, Gupta MK. Primary synovial sarcoma of the lung: a rare presentation, diagnostic dilemma and review of literature. BMJ Case Rep. 2020;13(11):e237678. doi: 10.1136/bcr-2020-237678

[8] Pandey L., Joseph D., Pasricha R., Gupta M.K. Primary synovial sarcoma of the lung: a rare presentation, diagnostic dilemma and review of literature // BMJ Case Rep. 2020. Vol. 13, N 11. P. e237678. doi: 10.1136/bcr-2020-237678

[9] Cabuk D, Ustuner B, Akgul AG, et al. Primary synovial sarcoma of lung. Korean J Thorac Cardiovasc Surg. 2014;47(3):306–309. doi: 10.5090/kjtcs.2014.47.3.306

[10] Cabuk D., Ustuner B., Akgul A.G., et al. Primary synovial sarcoma of lung // Korean J Thorac Cardiovasc Surg. 2014. Vol. 47, N 3. P. 306–309. doi: 10.5090/kjtcs.2014.47.3.306

[11] Kuruva SP, Bala S, Konatam ML, et al. Clinicopathological features, treatment and survival outcomes of synovial sarcoma. South Asian J Cancer. 2018;7(4):270–272. doi: 10.4103/sajc.sajc_269_17

[12] Kuruva S.P., Bala S., Konatam M.L., et al. Clinicopathological features, treatment and survival outcomes of synovial sarcoma // South Asian J Cancer. 2018. Vol. 7, N 4. P. 270–272. doi: 10.1136/bcr-2020-237678

[13] Rahmaniar D, Maranatha D. The early-stage of primary pulmonary synovial sarcoma: a case report. Int J Surg Case Rep. 2022;95:107251. doi: 10.1016/j.ijscr.2022.107251

[14] Rahmaniar D., Maranatha D. The early-stage of primary pulmonary synovial sarcoma: а case report // Int J Surg Case Rep. 2022. Vol. 95. P. 107251. doi: 10.1016/j.ijscr.2022.107251

[15] Woo WL, Panagiotopoulos N, Gvinianidze L, et al. Primary synovial sarcoma of the lung: can haemothorax be the first manifestation? J Thorac Dis. 2014;6(12): E249–E251. doi: 10.3978/j.issn.2072-1439.2014.11.01

[16] Woo W.L., Panagiotopoulos N., Gvinianidze L., et al. Primary synovial sarcoma of the lung: can haemothorax be the first manifestation? // J Thorac Dis. 2014. Vol. 6, N 12. P. E249–E251. doi: 10.3978/j.issn.2072-1439.2014.11.01

[17] Tetta C, Montrone G, Longhi A, et al. Chemosensitivity of lung metastatic high-grade synovial sarcoma. J Clin Med. 2021;10(24):5956. doi: 10.3390/jcm10245956

[18] Tetta C., Montrone G., Longhi A., et al. Chemosensitivity of lung metastatic high-grade synovial sarcoma // J Clin Med. 2021. Vol. 10, N 24. P. 5956. doi: 10.3390/jcm10245956

[19] Watzka SB, Setinek U, Prosch H, Müller MR. Primary synovial sarcoma of the lung as an incidental finding. Interact Cardiovasc Thorac Surg. 2009;9(6):1026–1028, doi: 10.1510/icvts.2009.213934

[20] Watzka S.B., Setinek U., Prosch H., Müller M.R. Primary synovial sarcoma of the lung as an incidental finding // Interact Cardiovasc Thorac Surg. 2009. Vol. 9, N 6. P. 1026–1028. doi: 10.1510/icvts.2009.213934

[21] Egorenkov VV, Bohjan AJu, Nesterova AI, i dr. Prakticheskie rekomendacii po le-karstvennomu lecheniju sarkom mjagkih tkaneĭ. Zlokachestvennye opuholi: Praktiche-skie rekomendacii RUSSCO #3s2. 2022. T. 12. S. 330–352. (In Russ).

[22] Егоренков В.В., Бохян А.Ю., Нестерова А.И., и др. Практические рекомендации по лекарственному лечению сарком мягких тканей // Злокачественные опухоли: Практические рекомендации RUSSCO #3s2. 2022. Т. 12. С. 330–352.

[23] Ichimura H, Kikuchi S, Ozawa Y, Matsuzaki K. Primary synovial sarcoma of the lung successfully resected under temporary bypass. Interact Cardiovasc Thorac Surg. 2013;17(3):588–590. doi: 10.1093/icvts/ivt234

[24] Ichimura H., Kikuchi S., Ozawa Y., Matsuzaki K. Primary synovial sarcoma of the lung successfully resected under temporary bypass // Interact Cardiovasc Thorac Surg. 2013. Vol. 17, N 3. P. 588–590. doi: 10.1093/icvts/ivt234

RIGHTS & PERMISSIONS

Eco-Vector