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Metastatic pulmonary synovial sarcoma: A double coincidence: Case report. Radiol Case Rep 2022; 18:878-881. [PMID: 36589488 PMCID: PMC9798112 DOI: 10.1016/j.radcr.2022.11.058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Revised: 11/16/2022] [Accepted: 11/21/2022] [Indexed: 12/24/2022] Open
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.
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2
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Manole S, Pintican R, Palade E, Duma MM, Dadarlat-Pop A, Schiau C, Bene I, Rancea R, Miclea D, Manole V, Molnar A, Solomon C. Primary Pericardial Synovial Sarcoma: A Case Report and Literature Review. Diagnostics (Basel) 2022; 12:diagnostics12010158. [PMID: 35054325 PMCID: PMC8774691 DOI: 10.3390/diagnostics12010158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Revised: 12/30/2021] [Accepted: 01/03/2022] [Indexed: 11/16/2022] Open
Abstract
We report a case of a 52-year-old woman who was referred to our institution with a superior vena cava syndrome and was investigated through echocardiography, CT and MRI revealing a well-defined, encapsulated pericardial mass. The pathology, correlated with the immunohistochemical analysis, concluded it was an extremely rare primary pericardial synovial sarcoma. The patient underwent surgery and chemotherapy with a 16-month disease-free survival and passed away after a contralateral aggressive relapse. Moreover, we discuss the role of each imaging modality together with their pericardial synovial sarcoma reported features.
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Affiliation(s)
- Simona Manole
- Department of Radiology, “Niculae Stancioiu” Heart Institute, 400001 Cluj-Napoca, Romania;
- Department of Radiology, “Iuliu Hatieganu” University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania; (C.S.); (I.B.)
| | - Roxana Pintican
- Department of Radiology, “Iuliu Hatieganu” University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania; (C.S.); (I.B.)
- Correspondence: (R.P.); (C.S.)
| | - Emanuel Palade
- Department of Cardiovascular and Thoracic Surgery, “Iuliu Hatieganu” University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania; (E.P.); (A.M.)
- Department of Thoracic Surgery, Leon Daniello“ Pneumophtysiology Hospital Cluj-Napoca, 400332 Cluj-Napoca, Romania
| | | | - Alexandra Dadarlat-Pop
- Cardiology Department, Heart Institute “N. Stăncioiu”, 400001 Cluj-Napoca, Romania; (A.D.-P.); (R.R.)
- Department of Internal Medicine, Faculty of Medicine, “Iuliu Hatieganu” University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania
| | - Calin Schiau
- Department of Radiology, “Iuliu Hatieganu” University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania; (C.S.); (I.B.)
| | - Ioana Bene
- Department of Radiology, “Iuliu Hatieganu” University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania; (C.S.); (I.B.)
| | - Raluca Rancea
- Cardiology Department, Heart Institute “N. Stăncioiu”, 400001 Cluj-Napoca, Romania; (A.D.-P.); (R.R.)
| | - Diana Miclea
- Department of Medical Genetics, “Iuliu Hatieganu” University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania;
| | - Viorel Manole
- Department of Cardiovascular Surgery, Heart Institute “N. Stăncioiu”, 400001 Cluj-Napoca, Romania;
| | - Adrian Molnar
- Department of Cardiovascular and Thoracic Surgery, “Iuliu Hatieganu” University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania; (E.P.); (A.M.)
- Department of Cardiovascular Surgery, Heart Institute “N. Stăncioiu”, 400001 Cluj-Napoca, Romania;
| | - Carolina Solomon
- Department of Radiology, “Iuliu Hatieganu” University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania; (C.S.); (I.B.)
- Correspondence: (R.P.); (C.S.)
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Chen L, Zhu X, Zhu R, Jin X, Tan L, Chen Y. Cardiopulmonary bypass does not consequentially contribute to postoperative distant metastasis of giant refractory thoracic tumors: A retrospective study with long-term follow-up. Thorac Cancer 2021; 12:2990-2995. [PMID: 34532966 PMCID: PMC8590891 DOI: 10.1111/1759-7714.14162] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Revised: 09/03/2021] [Accepted: 09/04/2021] [Indexed: 12/01/2022] Open
Abstract
Background Few clinical research studies with long‐term follow‐up have revealed whether cardiopulmonary bypass (CPB) increases the risk of postoperative distant metastasis in patients with giant refractory thoracic tumors. The present study evaluated the risk of distant metastasis after surgery utilizing CPB with long‐term follow‐up. Methods Clinical data for patients with giant refractory thoracic tumors who underwent resection with the use of CPB in the Second Affiliated Hospital of Soochow University during the past 11 years were retrospectively reviewed. Results Of the 14 patients with giant refractory thoracic tumors who had undergone surgery under CPB, 10 patients (71.4%) were completely resected. Twelve patients were followed up for 13–127 months with 10 patients were completely resected and two patients could not be completely resected due to severe tissue invasion. Three patients (25%) suffered from distant metastasis, and four patients (33.3%) experienced local recurrence. Only one patient (1/10) with complete resection suffered from distant metastasis, while two patients (2/10) experienced local recurrence. Two patients (2/2) with major resection suffered from both distant metastasis and local recurrence. Median overall survival for patients who have been regularly followed up was 50 months with 1‐, 5‐, and 10‐year survival of 100%, 75%, and 66.7%. No difference was found between the distant metastasis survival and the local recurrence survival. (p = 0.99). Conclusions CPB is an effective strategy for complete resection of the giant refractory thoracic tumors with an acceptable risk of postoperative distant metastasis for some patients.
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Affiliation(s)
- Lei Chen
- Department of Thoracic Surgery, the Second Affiliated Hospital of Soochow University, Suzhou, China
| | - Xuejuan Zhu
- Department of Thoracic Surgery, the Second Affiliated Hospital of Soochow University, Suzhou, China
| | - Rongying Zhu
- Department of Thoracic Surgery, the Second Affiliated Hospital of Soochow University, Suzhou, China
| | - Xing Jin
- Department of Thoracic Surgery, the Second Affiliated Hospital of Soochow University, Suzhou, China
| | - Liping Tan
- Department of Nursing, the Second Affiliated Hospital of Soochow University, Suzhou, China
| | - Yongbing Chen
- Department of Thoracic Surgery, the Second Affiliated Hospital of Soochow University, Suzhou, China
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4
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Khamaysi I, Naroditsky I, Malkin L. Primary synovial sarcoma of the mediastinum: a rare tumor diagnosed by endoscopic ultrasound-fine needle biopsy (EUS-FNB)-Cytomorphologic, immunohistochemical, and molecular analysis. Clin J Gastroenterol 2021; 14:961-964. [PMID: 33792887 DOI: 10.1007/s12328-021-01393-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Accepted: 03/18/2021] [Indexed: 10/21/2022]
Abstract
Primary synovial sarcoma is exceedingly rare in the mediastinum. The differential diagnosis of this rare tumor is complex as a wide array of primary and metastatic tumors occur in this site.A definite diagnosis might be challenging even after tissue sampling. Immunohistochemistry can be very helpful and supportive for the diagnosis, but still inadequate in some cases as these tumors can mimic histopathologically other soft tissue tumors. Hence, in some case, an advanced pathological molecular analysis is needed.Endoscopic ultrasound (EUS) is an important diagnostic tool for mediastinal tumors. While EUS-fine needle aspiration (EUS-FNA) samples are usually inadequate for advanced pathological analysis, tissue acquisition by the newer generation of EUS-fine needle biopsy (EUS-FNB) needles might be sufficient.Here, we present the first report on primary mediastinal synovial sarcoma diagnosed by an immunohistochemical and FISH analysis performed on EUS-FNB tissue sample.
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Affiliation(s)
- Iyad Khamaysi
- The Ruth and Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, POB 9602, 31096, Haifa, Israel. .,Invasive Endoscopy Unit, Department Gastroenterology and Hepatology, Rambam Health Care Campus, Haifa, Israel.
| | - Inna Naroditsky
- Department of Pathology, Rambam Health Care Campus, Haifa, Israel
| | - Leonid Malkin
- Department of Pathology, Rambam Health Care Campus, Haifa, Israel
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5
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Urbini M, Astolfi A, Indio V, Nannini M, Pizzi C, Paolisso P, Tarantino G, Pantaleo MA, Saponara M. Genetic aberrations and molecular biology of cardiac sarcoma. Ther Adv Med Oncol 2020; 12:1758835920918492. [PMID: 32489430 PMCID: PMC7238448 DOI: 10.1177/1758835920918492] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2019] [Accepted: 03/19/2020] [Indexed: 12/19/2022] Open
Abstract
Cardiac tumors are rare and complex entities. Early assessment and differentiation between non-neoplastic and neoplastic masses, be they benign or malignant, is essential for guiding diagnosis, determining prognosis, and planning therapy. Cardiac sarcomas represent the most frequent primary malignant histotype. They could have manifold presentations so that the diagnosis is often belated. Moreover, considering their rarity and the limitation due to the cardiac location itself, the optimal multimodal management of patients affected by primary cardiac sarcomas still remains highly difficult and outcome dismal. Therefore, there is an urgent need to improve these results mainly focusing on more adequate tools for prompt diagnosis and exploring new and more effective therapies. Knowledge about the molecular landscape and pathogenesis of cardiac sarcoma is even more limited due to the rarity of this disease. In this sense, the molecular characterization of heart tumors could unfold potentially novel, druggable targets. In this review, we focused on genetic aberrations and molecular biology of cardiac sarcomas, collecting the scarce information available and resuming all the molecular findings discovered in each tumor subtype, with the aim to get further insights on mechanisms involved in tumor growth and to possibly highlight specific molecular profiles that can be used as diagnostic tests and unveil new clinically actionable targets in this tricky and challenging disease.
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Affiliation(s)
- Milena Urbini
- “Giorgio Prodi” Cancer Research Center,
University of Bologna, Bologna, Italy
| | - Annalisa Astolfi
- “Giorgio Prodi” Cancer Research Center,
University of Bologna, Bologna, Italy
| | - Valentina Indio
- “Giorgio Prodi” Cancer Research Center,
University of Bologna, Bologna, Italy
| | - Margherita Nannini
- Department of Specialized, Experimental and
Diagnostic Medicine, Medical Oncology Unit, Sant’Orsola-Malpighi Hospital,
University of Bologna, Bologna, Italy
| | - Carmine Pizzi
- Department of Specialized, Experimental and
Diagnostic Medicine, Cardiology and Transplantation, Sant’Orsola-Malpighi
Hospital, University of Bologna, Bologna, Italy
| | - Pasquale Paolisso
- Department of Specialized, Experimental and
Diagnostic Medicine, Cardiology and Transplantation, Sant’Orsola-Malpighi
Hospital, University of Bologna, Bologna, Italy
| | - Giuseppe Tarantino
- “Giorgio Prodi” Cancer Research Center,
University of Bologna, Bologna, Italy
| | - Maria Abbondanza Pantaleo
- “Giorgio Prodi” Cancer Research Center,
University of Bologna, Bologna, Italy
- Department of Specialized, Experimental and
Diagnostic Medicine, Medical Oncology Unit, Sant’Orsola-Malpighi Hospital,
University of Bologna, Bologna, Italy
| | - Maristella Saponara
- Department of Specialized, Experimental and
Diagnostic Medicine, Medical Oncology Unit, Sant’Orsola-Malpighi Hospital,
University of Bologna, Via Massarenti, 9, Bologna, Bologna 40138,
Italy
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6
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Salvador-Coloma C, Saigí M, Díaz-Beveridge R, Penín RM, Pané-Foix M, Mayordomo E, Melián M, Schuler M, García Del Muro X, Font de Mora J. Identification Of Actionable Genetic Targets In Primary Cardiac Sarcomas. Onco Targets Ther 2019; 12:9265-9275. [PMID: 31807008 PMCID: PMC6847994 DOI: 10.2147/ott.s214319] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2019] [Accepted: 08/09/2019] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Primary cardiac tumors are extremely rare; most are myxomas with a benign prognosis. However, primary sarcomas are highly aggressive and treatment options are limited. Radical surgery is often not feasible and conventional therapies provide only modest results. Due to the rare nature of primary cardiac tumors, there are no proper randomized studies to guide treatment. Their complexity requires alternative approaches in order to improve treatment efficacy. METHODS We isolated DNA from 5 primary cardiac sarcomas; the quality of DNA from 3 of them was sufficient to perform high-resolution single nucleotide polymorphism (SNP) array analysis. RESULTS In the present study, molecular karyotyping revealed numerous segmental chromosomal alterations and amplifications affecting actionable genes that may be involved in disease initiation and/or progression. These include chromosomal break flanking AKT2 in undifferentiated pleomorphic rhabdomyosarcoma, chromosomal break in promoter of TERT, and gain of CDK4 and amplification of MDM2 in inflammatory myofibroblastic tumor. We detected segmental break flanking MOS in high-grade myxofibrosarcoma. In addition, the high number of chromosomal aberrations in high-grade myxofibrosarcoma may cause multiple tumor-specific epitopes, supporting the study of immunotherapy treatment in this type of aggressive tumor. CONCLUSION Our results provide a genetic rationale that supports an alternative, personalized therapeutic management of primary cardiac sarcomas.
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Affiliation(s)
- Carmen Salvador-Coloma
- Department of Medical Oncology, Hospital Universitari i Politècnic La Fe, Valencia, Spain
- Laboratory of Cellular and Molecular Biology, Clinical and Translational Research in Cancer, Instituto de Investigación Sanitaria La Fe, Valencia, Spain
| | - María Saigí
- Department of Medical Oncology, Institut Català Oncologia, IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Roberto Díaz-Beveridge
- Department of Medical Oncology, Hospital Universitari i Politècnic La Fe, Valencia, Spain
| | - Rosa María Penín
- Department of Pathology, Hospital Universitari de Bellvitge, Barcelona, Spain
| | - María Pané-Foix
- Department of Pathology, Hospital Universitari de Bellvitge, Barcelona, Spain
| | - Empar Mayordomo
- Department of Pathology, Hospital Universitari i Politècnic La Fe, Valencia, Spain
| | - Marcos Melián
- Department of Medical Oncology, Hospital Universitari i Politècnic La Fe, Valencia, Spain
| | - Mona Schuler
- Department of Cardiac Surgery, Hospital Universitari i Politècnic La Fe, Valencia, Spain
| | - Xavier García Del Muro
- Department of Medical Oncology, Institut Català Oncologia, IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Jaime Font de Mora
- Laboratory of Cellular and Molecular Biology, Clinical and Translational Research in Cancer, Instituto de Investigación Sanitaria La Fe, Valencia, Spain
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Duran-Moreno J, Kampoli K, Kapetanakis EI, Mademli M, Koufopoulos N, Foukas PG, Kostopanagiotou K, Tomos P, Koumarianou A. Pericardial Synovial Sarcoma: Case Report, Literature Review and Pooled Analysis. In Vivo 2019; 33:1531-1538. [PMID: 31471401 PMCID: PMC6754991 DOI: 10.21873/invivo.11633] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2019] [Revised: 07/01/2019] [Accepted: 07/08/2019] [Indexed: 02/06/2023]
Abstract
BACKGROUND Pericardial synovial sarcomas (PSS) are very rare tumors, with dismal prognosis and limited data. We describe the clinical features and identify prognostic factors of primary PSS. CASE REPORT We describe the case of a 56-year-old male patient with PSS managed by the multidisciplinary team of thoracic oncology. The therapeutic plan comprised surgery, chemotherapy, stereotactic radiosurgery and targeted therapy, with excellent results. MATERIALS AND METHODS Data from 37 cases reported in English during the past 20 years were gathered and analyzed. PSS was found to occur at a mean age of 36±17.082 (range=13-67) years. Survival analysis was performed on 20 cases with follow-up of at least 6 months. CONCLUSION Only complete resection of the tumor seems to be an independent prognostic factor. To our knowledge, this is the first report on the safety and effectivity of pazopanib in PSS and may provide guidance for similar cases in the future.
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Affiliation(s)
- Jose Duran-Moreno
- Hematology Oncology Unit, Fourth Department of Internal Medicine, Attikon University Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Katerina Kampoli
- Hematology Oncology Unit, Fourth Department of Internal Medicine, Attikon University Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Emmanouil I Kapetanakis
- Department of Thoracic Surgery, Attikon University Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Maria Mademli
- Second Department of Radiology, Attikon University Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Nektarios Koufopoulos
- Second Department of Pathology, Attikon University Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Periklis G Foukas
- Second Department of Pathology, Attikon University Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Kostas Kostopanagiotou
- Department of Thoracic Surgery, Attikon University Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Periklis Tomos
- Department of Thoracic Surgery, Attikon University Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Anna Koumarianou
- Hematology Oncology Unit, Fourth Department of Internal Medicine, Attikon University Hospital, National and Kapodistrian University of Athens, Athens, Greece
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8
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Coli A, Cassano A, Novello M, Ranelletti FO, Lauriola L. Primary cardiac synovial sarcoma: A review correlating outcomes with surgery and adjuvant therapy. J Card Surg 2019; 34:1321-1327. [PMID: 31441555 DOI: 10.1111/jocs.14214] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
BACKGROUND Cardiac synovial sarcoma (CSS) is an extremely rare malignant tumor with a severe prognosis, due to frequent relapses and metastases. To obtain useful information for treatment protocols, we analyzed survival and therapy data from the cases reported in the literature. METHODS A search of MEDLINE was performed throughout December 2018. Using key words relating to primary CSS, we collected from the literature a total of 97 cases, mainly consisting of single case reports. To identify predictors of overall survival, statistical analyses were performed on a selected cohort of 55 patients for whom relevant clinicopathological data were available, including surgery and adjuvant therapy. RESULTS The univariable analysis revealed that patients in their first three decades of life have better overall survival. The univariable analysis also showed that patients not receiving adjuvant chemotherapy are at increased risk of death. In the multivariable analysis, tumor resection and chemotherapy are factors significantly improving overall survival. CONCLUSION The survival of patients with CSS is positively influenced by a young patient's age and greatly improved by the administration of chemotherapy, even in the absence of tumor resection.
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Affiliation(s)
- Antonella Coli
- Department of Pathology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma-Università Cattolica del Sacro Cuore, Rome, Italy
| | - Alessandra Cassano
- Department of Medical Oncology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma-Università Cattolica del Sacro Cuore, Rome, Italy
| | | | - Franco O Ranelletti
- Department of Histology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma-Università Cattolica del Sacro Cuore, Rome, Italy
| | - Libero Lauriola
- Department of Pathology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma-Università Cattolica del Sacro Cuore, Rome, Italy
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9
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Madabhavi I, Patel A, Anand A, Panchal H, Parikh S. Primary mediastinal synovial sarcoma with subsequent development of primary adenoid cystic carcinoma of lung presenting as superior vena cava syndrome. CLINICAL RESPIRATORY JOURNAL 2016; 12:306-311. [PMID: 26992072 DOI: 10.1111/crj.12476] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/08/2014] [Revised: 01/28/2016] [Accepted: 02/08/2016] [Indexed: 12/25/2022]
Abstract
Primary mediastinal sarcomas are aggressive tumors with a very rare incidence. This report describes the case of a 35 year old male patient who presented with acute symptoms of dyspnoea, facial puffiness, engorged neck veins and hoarseness of voice. With the clinical picture consistent with the superior vena caval (SVC) syndrome, the patient was investigated with computed tomography of the chest. This revealed a large soft tissue density mass lesion compressing the SVC along with other critical superior mediastinal structures. Histopathological evaluation of the mass revealed features consistent with a soft tissue sarcoma and positive staining was observed for vimentin and S-100. Cytogenetic analysis by fluorescent in-situ hybridization (FISH) demonstrated the t(X: 18) translocation. Thus diagnosis was established as primary mediastinal synovial sarcoma. Patient was treated with three-cycles of neo-adjuvant (ifosfamide 2400mg/m2 on days 1-5 and doxorubicin 37.5 mg/m2 on days 1 & 2) chemotherapy, to which there was a partial response as per the RECIST criteria. Surgical excision of the mediastinal mass was performed, and further post-operative treatment with adjuvant chemo-radiotherapy was provided. Patient was under regular surveillance at our clinic and remains free of symptoms one-year after treatment completion. But after 14 months of treatment completion patient again had symptoms of progressive dyspnea, hoareness of voice and mild facial puffiness over a period of 2 months. On further investigating he was found to have right-sided centrally located mass with cystic and necrotic changes with extension and compression of trachea, SVC, right upper lobe bronchus and its branches. Histopathological examination of the biopsy from the lesion revealed adenoid cystic carcinoma of the lung. Rest of the metastatic work up was within normal. Immunohistochemistry of the specimen revealed c-Kit positivity. In view of the morbid second surgery he was put on Imatinib 400mg once a day and celecoxib 200mg twice a day. After 4 months patient had partial response and presently continuing with the same regimen. Extensive literature search didn't reveal much information on combined primary mediastinal sarcoma and adenoid cystic carcinoma of lung.
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Affiliation(s)
- Irappa Madabhavi
- Department of Medical and Pediatric Oncology, GCRI, Ahmedabad, Gujarat, India
| | - Apurva Patel
- Department of Medical and Pediatric Oncology, GCRI, Ahmedabad, Gujarat, India
| | - Asha Anand
- Department of Medical and Pediatric Oncology, GCRI, Ahmedabad, Gujarat, India
| | - Harsha Panchal
- Department of Medical and Pediatric Oncology, GCRI, Ahmedabad, Gujarat, India
| | - Sonia Parikh
- Department of Medical and Pediatric Oncology, GCRI, Ahmedabad, Gujarat, India
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10
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Ershadi R, Rahim M, Davari H. Primary mediastinal synovial sarcoma: A rare case report. Int J Surg Case Rep 2016; 27:169-171. [PMID: 27621098 PMCID: PMC5021781 DOI: 10.1016/j.ijscr.2016.08.037] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2016] [Revised: 08/24/2016] [Accepted: 08/24/2016] [Indexed: 11/30/2022] Open
Abstract
Synovial sarcomas commonly occur in the extremities of young adults. A primary occurrence in the mediastinum is very rare with only a few reported cases in the world literature. This paper highlights the importance of recognizing an unusual presentation of this aggressive neoplasm to aid appropriate clinical management.
Introduction Synovial sarcomas commonly occur in the extremities of young adults. A primary occurrence in the mediastinum is very rare with only a few reported cases in the world literature. We report a case of mediastinal synovial sarcoma. This paper is about a 47-year-old male who presented with retrosternal chest pain and shortness of breath on exertion. Imaging showed an anterior mediastinal mass. Pathological examination of the resected mass showed a biphasic neoplasm with a spindle cell component admixed with gland-like elements. The tumor showed positive staining with cytokeratin, epithelial membrane antigen and vimentin confirming the diagnosis of a biphasic synovial sarcoma. Discussion A wide range of neoplasms, both primary and metastatic, occur in the mediastinum, which pose considerable diagnostic difficulties. A synovial sarcoma should always be considered in the differential diagnosis, and immunohistochemistry is an important adjuvant tool in this situation. Conclusion This paper highlights the importance of recognizing an unusual presentation of this aggressive neoplasm to aid appropriate clinical management.
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Affiliation(s)
- Reza Ershadi
- Department of Thoracic Surgery, Imam Khomeini Hospital Complex, Tehran University of Medical Science, Iran.
| | - Mohamadbagher Rahim
- Department of Thoracic Surgery, Imam Khomeini Hospital Complex, Tehran University of Medical Science, Iran
| | - Hamidreza Davari
- Department of Thoracic Surgery, Imam Khomeini Hospital Complex, Tehran University of Medical Science, Iran
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11
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Youn HC, Lee Y, Kim SC. Pericardial synovial sarcoma presenting with large recurrent pericardial effusion. J Thorac Dis 2016; 8:E412-6. [PMID: 27293869 DOI: 10.21037/jtd.2016.04.57] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Primary pericardial synovial sarcoma is an extremely rare disease with a dismal prognosis. Its main presenting symptoms are a large pericardial effusion, signs of cardiac tamponade, and visualization of a pericardial mass on echocardiography. However, the systemic symptoms of fever, cough, and night sweats may present a clinical picture without any apparent pericardial mass on diagnostic imaging, potentially impeding the diagnosis. We report the case of a 34-year-old patient with fever and recurrent pericardial effusion for 2 years, who was diagnosed with primary pericardial synovial sarcoma after 2-year follow-up echocardiography.
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Affiliation(s)
- Hyo Chul Youn
- Department of Thoracic and Cardiovascular Surgery, Kyung Hee University Medical Center, Seoul, Korea
| | - Yangyoun Lee
- Department of Thoracic and Cardiovascular Surgery, Kyung Hee University Medical Center, Seoul, Korea
| | - Soo-Cheol Kim
- Department of Thoracic and Cardiovascular Surgery, Kyung Hee University Medical Center, Seoul, Korea
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12
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Goldblatt J, Saxena P, McGiffin DC, Zimmet A. Pericardial Synovial Sarcoma: A Rare Clinical Entity. J Card Surg 2015; 30:801-4. [DOI: 10.1111/jocs.12609] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Joshua Goldblatt
- Department of Cardiothoracic Surgery; The Alfred Hospital; Melbourne Australia
| | - Pankaj Saxena
- Department of Cardiothoracic Surgery; The Alfred Hospital; Melbourne Australia
| | - David C. McGiffin
- Department of Cardiothoracic Surgery; The Alfred Hospital; Melbourne Australia
| | - Adam Zimmet
- Department of Cardiothoracic Surgery; The Alfred Hospital; Melbourne Australia
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13
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Rea G, Somma F, Valente T, Antinolfi G, Di Grezia G, Gatta G. Primary mediastinal giant synovial sarcoma: A rare case report. THE EGYPTIAN JOURNAL OF RADIOLOGY AND NUCLEAR MEDICINE 2015. [DOI: 10.1016/j.ejrnm.2014.11.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
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Primary synovial sarcomas of the mediastinum: a systematic review and pooled analysis of the published literature. ISRN ONCOLOGY 2014; 2014:412527. [PMID: 24563786 PMCID: PMC3916017 DOI: 10.1155/2014/412527] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/24/2013] [Accepted: 11/10/2013] [Indexed: 12/12/2022]
Abstract
Background. The aim of this systematic review is to attempt to provide a descriptive analysis for cases of synovial sarcoma (SS) arising in the mediastinum and to analyze prognostic factors. Methods. We performed PubMed database search in July 2013. Twenty-two studies, which included 40 patients, form the basis of this review. Demographic and disease-related factors were analyzed for possible influence on survival. Findings were compared with extremity SS studies reported in literature. Results. Sixteen cases (40%) presented with locally advanced unresectable disease, 2 (5%) with metastatic disease, and 22 (55%) with localized resectable disease. Median tumor size was 11 cm (range: 5–20 cm). Thirty patients were assessable for survival and had a 5-year OS of 36%. Completeness of resection was the only factor associated with significant improvement in OS (5-year survival of 63% and 0% in favor of complete resection, P = 0.003). Conclusion. Mediastinal SS is associated with poor prognosis as more cases are diagnosed at an advanced stage and with larger tumor size compared to extremity SS. Complete surgical resection is the only identified factor associated with better prognosis and may result in survival outcomes that are comparable with those for localized SS of the extremity.
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15
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Phatak P, Khanagavi J, Aronow WS, Puri S, Yusuf Y, Puccio C. Pericardial synovial sarcoma: challenges in diagnosis and management. F1000Res 2014; 3:15. [PMID: 24715974 PMCID: PMC3954165 DOI: 10.12688/f1000research.3-15.v2] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/03/2014] [Indexed: 12/20/2022] Open
Abstract
Introduction: Pericardial synovial sarcoma is an extremely rare tumor with poor prognosis. Timely diagnosis and aggressive multimodal management improves patient outcome. We present our experience of diagnosis and management of a young patient with monophasic synovial sarcoma arising from pericardium. Case: A 27-year-old man presented with dyspnea and cough of three weeks duration. Examination revealed sinus tachycardia, distant heart sounds and elevated jugular venous pressure. Chest X-ray showed widened mediastinum. Transthoracic echocardiogram (TTE) noted large pericardial effusion with tamponade physiology. Therapeutic pericardiocentesis yielded hemorrhagic fluid. Computed tomography (CT) of the chest showed persistent pericardial effusion and a left anterior mediastinal mass. Left anterior thoracotomy, pericardial window and left anterior mediastinotomy were done, revealing a well-encapsulated gelatinous tumor originating from the pericardium. Histology and immunohistochemical profile showed the tumor to be a monophasic synovial sarcoma. Fluorescent in-situ hybridization (FISH) was positive for SS18 (SYT) gene rearrangement on chromosome 18q11, substantiating the diagnosis. Work-up for metastases was negative. Neo-adjuvant chemotherapy with high dose ifosfamide led to substantial reduction in the size of the tumor. The patient underwent surgical resection and external beam radiation therapy (EBRT) post surgery. He had symptom-free survival for 8 months prior to local recurrence. This was managed with left lung upper lobectomy and follow-up chemotherapy with docetaxel. The patient is currently stable with an acceptable functional status. Conclusion: In patients with pericardial effusions of unknown etiology, multiple modalities of cardiac imaging must be employed if there is suspicion of a pericardial mass. CT and magnetic resonance imaging (MRI) are useful to evaluate for pericardial thickening or masses in addition to TTE. Treatment of synovial sarcoma is not well established. Surgery is the cornerstone of treatment. In non-resectable tumors, aggressive neo-adjuvant chemotherapy with ifosfamide followed by surgical resection and EBRT may lead to improved outcome.
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Affiliation(s)
- Prajakta Phatak
- Department of Medicine, Westchester Medical Center / New York Medical College, Valhalla, NY 10595, USA
| | - Jagadish Khanagavi
- Department of Medicine, Westchester Medical Center / New York Medical College, Valhalla, NY 10595, USA
| | - Wilbert S Aronow
- Division of Cardiology, Westchester Medical Center/ New York Medical College, Valhalla, NY 10595, USA
| | - Sonam Puri
- Department of Medicine, University of Connecticut, Farmington, CT 06030, USA
| | - Yasmin Yusuf
- Department of Pathology, Westchester Medical Center / New York Medical College, Valhalla, NY 10595, USA
| | - Carmelo Puccio
- Division of Oncology, Westchester Medical Center/ New York Medical College, Valhalla, NY 10595, USA
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16
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Chekrine T, Sahraoui S, Cherkaoui S, Eddakkaoui H, Labsaili H, Marouane S, El Attar H, Zamiati S, Mehadji BE, Benider A. Primary pericardial synovial sarcoma: A case report and literature review. J Cardiol Cases 2013; 9:40-43. [PMID: 30546781 DOI: 10.1016/j.jccase.2013.09.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2013] [Revised: 08/14/2013] [Accepted: 09/14/2013] [Indexed: 11/18/2022] Open
Abstract
Primary pericardial synovial sarcoma is extremely rare, with few published cases in the literature. We report the case of an adolescent aged 13 years with primary pericardial synovial sarcoma discovered during tamponade, confirmed by molecular biology, and for whom treatment combined radiosurgery and adjuvant chemotherapy. The particularity of the case we are reporting stems from the young age of our patient (13 years) as well as the duration of remission, which is quite long (21 months) prior to a superior mediastinal relapse compared to cases reported in the literature. <Learning objective: Synovial sarcoma is difficult to diagnose and has a poor prognosis. Here, a 13-year-old diagnosed with primary pericardial synovial sarcoma was treated with combined radiosurgery and adjuvant chemotherapy leading to continuous remission for 21 months. This regimen could be used to successfully manage future patients. Molecular biology is useful in the diagnosis of synovial sarcoma through the identification of t(X;18) translocation in atypical locations as in the present case.>.
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Affiliation(s)
- Tarik Chekrine
- Department of Radiotherapy-Oncology, UHC Ibn Rochd, Casablanca, Morocco
| | - Souha Sahraoui
- Department of Radiotherapy-Oncology, UHC Ibn Rochd, Casablanca, Morocco
| | - Siham Cherkaoui
- Department of Pediatric Hematology and Oncology, 20 Août Hospital, UHC Ibn Rochd, Casablanca, Morocco
| | - Houda Eddakkaoui
- Department of Radiotherapy-Oncology, UHC Ibn Rochd, Casablanca, Morocco
| | - Hicham Labsaili
- Department of Cardiovascular Surgery, UHC Ibn Rochd, Casablanca, Morocco
| | - Soufia Marouane
- Central Department of Pathological Anatomy, UHC Ibn Rochd, Casablanca, Morocco
| | - Hicham El Attar
- Anatomy and Pathological Cytology Laboratory, Moulay Idriss I, Casablanca, Morocco
| | - Soumaya Zamiati
- Central Department of Pathological Anatomy, UHC Ibn Rochd, Casablanca, Morocco
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17
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Pericardial synovial sarcoma: a case report and review of the literature. Surg Today 2013; 44:2167-73. [DOI: 10.1007/s00595-013-0720-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2013] [Accepted: 06/14/2013] [Indexed: 02/07/2023]
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18
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Salah S, Al-Ibraheem A, Daboor A, Al-Hussaini M. Synovial sarcoma presenting with huge mediastinal mass: a case report and review of literature. BMC Res Notes 2013; 6:240. [PMID: 23800262 PMCID: PMC3701506 DOI: 10.1186/1756-0500-6-240] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2012] [Accepted: 06/19/2013] [Indexed: 11/10/2022] Open
Abstract
Background Synovial 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 presentation A 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. Conclusion Synovial 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.
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Affiliation(s)
- Samer Salah
- Department of Medical Oncology, King Hussein Cancer Center, Amman, Jordan.
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19
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Wang JG, Li NN. Primary cardiac synovial sarcoma. Ann Thorac Surg 2013; 95:2202-9. [PMID: 23647858 DOI: 10.1016/j.athoracsur.2013.01.030] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2013] [Revised: 01/10/2013] [Accepted: 01/18/2013] [Indexed: 11/27/2022]
Abstract
Primary cardiac synovial sarcoma is an extremely rare entity. The clinical and pathologic characteristics are still poorly understood, and prognostic factors influencing overall survival are still unknown. In the present study, all characteristics of reported patients, including sex, age, clinical presentations, laboratory tests, electrocardiogram, imaging findings, pathology, location, therapy, and follow-up were carefully reviewed and survival analysis was performed. The present study has summarized some key features and may provide an effective consultation for the diagnosis and treatment of the tumor.
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Affiliation(s)
- Ji-Gang Wang
- Department of Pathology, The Affiliated Hospital of Medical College, Qingdao University, Qingdao, China.
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20
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Wu X, Chen R, Zhao B. Pericardial synovial sarcoma in a dyspnoeic female with tuberculous pericarditis: A case report. Oncol Lett 2013; 5:1973-1975. [PMID: 23833678 PMCID: PMC3700802 DOI: 10.3892/ol.2013.1279] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2012] [Accepted: 03/21/2013] [Indexed: 12/04/2022] Open
Abstract
Synovial sarcomas of the pericardium are extremely rare and associated with poor survival rate. The current case report describes a 45-year-old female who presented with dyspnea upon exertion, a paroxysmal cough, night sweats and recurrent pericardial effusion. The patient was diagnosed with tuberculous pericarditis and received antituberculous drug therapy. Echocardiography and magnetic resonance imaging (MRI) revealed a pericardial mass lying predominantly over the right atrium. The patient was treated by surgical excision and a subsequent histological analysis confirmed the diagnosis of a pericardial synovial sarcoma. Under high power examination, a characteristic biphasic appearance consisting of hypercellular spindled cell sheets was observed. Immunohistochemistry demonstrated positive staining for epithelial membrane antigen (EMA), vimentin and Bcl 2. The patient was then referred for adjuvant chemotherapy with a combination of adriamycin and ifosfamide. The patient has since remained clinically free of disease for 32 months.
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Affiliation(s)
- Xia Wu
- Departments of Radiology, Sir Run Run Shaw Hospital, Zhejiang University College of Medicine and Sir Run Run Shaw Institute of Clinical Medicine, Hangzhou, Zhejiang 310016, P.R. China
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21
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Cheng Y, Sheng W, Zhou X, Wang J. Pericardial synovial sarcoma, a potential for misdiagnosis: clinicopathologic and molecular cytogenetic analysis of three cases with literature review. Am J Clin Pathol 2012; 137:142-9. [PMID: 22180488 DOI: 10.1309/ajcp34zvflautmgl] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Synovial sarcomas arising in unexpected locations may lead to diagnostic challenges. In this report, we describe 3 cases of synovial sarcoma that manifested clinically as primary pericardial lesions. All 3 cases occurred in men in their fourth decade. Fever, cough, chest pain, and chest distress were the most common symptoms. Histologically, 2 of the tumors were spindle cell monophasic, and 1 tumor was biphasic. By immunohistochemical studies, the tumor cells were positive for cytokeratins and epithelial membrane antigen. In addition, the tumor cells displayed focal immunoreactivity for calretinin, cytokeratin 5/6, and HBME-1, resulting in the initial interpretations of malignant mesotheliomas. None of the 3 cases were diagnosed correctly until subsequent molecular cytogenetic assays demonstrated the presence of SYT gene rearrangements. As there are overlapping morphologic features between pericardial synovial sarcoma and mesothelioma, molecular analysis is essential for differential diagnoses.
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22
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Yokouchi Y, Hiruta N, Oharaseki T, Ihara F, Oda Y, Ito S, Yamashita H, Ozaki S, Gomi T, Takahashi K. Primary cardiac synovial sarcoma: A case report and literature review. Pathol Int 2010; 61:150-5. [DOI: 10.1111/j.1440-1827.2010.02631.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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23
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Navaravong L, Miller BR, Rice KL, Deschamps C. An unusual cause of dyspepsia. Am J Med 2010; 123:510-3. [PMID: 20569754 DOI: 10.1016/j.amjmed.2010.02.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2009] [Revised: 02/02/2010] [Accepted: 02/04/2010] [Indexed: 11/16/2022]
Affiliation(s)
- Leenhapong Navaravong
- Department of Medicine, Veterans Affairs Medical Center, University of Minnesota, Minneapolis, MN 55455, USA.
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24
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Ito S, Hashimoto G, Hara H, Nakamura M. A pericardial tumor with a unique presentation. ACUTE CARDIAC CARE 2010; 12:37-39. [PMID: 19929265 DOI: 10.3109/17482940903406620] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Affiliation(s)
- Shingo Ito
- Division of Cardiovascular Medicine, Toho University Ohashi Medical Center, Tokyo, Japan.
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25
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26
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Koga S, Ikeda S, Urata J, Chijiwa R, Abe K, Hayashi T, Eishi K, Kohno S. Primary High-Grade Myofibroblastic Sarcoma Arising From the Pericardium. Circ J 2008; 72:337-9. [DOI: 10.1253/circj.72.337] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Seiji Koga
- Second Department of Internal Medicine, Nagasaki University School of Medicine
| | - Satoshi Ikeda
- Second Department of Internal Medicine, Nagasaki University School of Medicine
| | - Jungo Urata
- Second Department of Internal Medicine, Nagasaki University School of Medicine
| | - Risa Chijiwa
- Second Department of Internal Medicine, Nagasaki University School of Medicine
| | - Kuniko Abe
- Department of Pathology, Nagasaki University School of Medicine
| | | | - Kiyoyuki Eishi
- Department of Cardiovascular Surgery, Nagasaki University School of Medicine
| | - Shigeru Kohno
- Second Department of Internal Medicine, Nagasaki University School of Medicine
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27
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Hing SN, Marshall L, Al-Saadi R, Hargrave D. Primary pericardial synovial sarcoma confirmed by molecular genetic studies: a case report. J Pediatr Hematol Oncol 2007; 29:492-5. [PMID: 17609629 DOI: 10.1097/mph.0b013e3180640d2e] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Primary pericardial synovial sarcoma is an extremely rare tumor. The awkward tumor site and clinical features associated with quite advanced disease at presentation make obtaining adequate biopsy material challenging. Ambiguous histologic features may also make diagnosis difficult. We present a case of a 15-year-old patient with an original diagnosis of a spindle cell thymoma. After definitive surgery the diagnosis was amended to a primary pericardial synovial sarcoma. Molecular confirmation of the SYT-SSX fusion gene was critical in reaching an accurate diagnosis. This highlights the necessity for routine molecular genetic studies, so that patient therapy can be directed accordingly.
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Affiliation(s)
- Sandra N Hing
- Section of Paediatric Oncology, The Royal Marsden NHS Foundation Trust, Sutton, Surrey, UK
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28
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Schumann C, Kunze M, Kochs M, Hombach V, Rasche V. Pericardial synovial sarcoma mimicking pericarditis in findings of cardiac magnetic resonance imaging. Int J Cardiol 2007; 118:e83-4. [PMID: 17399807 DOI: 10.1016/j.ijcard.2007.01.029] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2006] [Accepted: 01/02/2007] [Indexed: 11/24/2022]
Abstract
We report a case of a 64-year-old woman with increasing shortness of breath due to massive pericardial effusion. Cardiac magnetic resonance imaging (CMRI) identified typical findings for pericarditis. Pericardectomy was needed due to suspicion of pericardial abscess formation. Histological examination of the resected tissue revealed an undifferentiated primary pericardial synovial sarcoma. The present case illustrates that pericardial tumours could be an important differential diagnosis to pericarditis, even if typical findings of pericarditis were present in CMRI.
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