Learning objectives
To do a review of the thoracic synovial sarcoma.
To illustrate different cases of thoracic synovial sarcoma, describe and recognize their radiological features with their pathological correlation.
Background
Concept
Synovial sarcoma (SS) is a high-grade sarcoma, representing 5-10% of all soft tissue sarcomas. It arises from primitive mesenchymal cells with epithelial and not synovial differentiation as previously thought. (1)
It mainly affects the extremities (about 80%), near the joints of the lower and upper extremities (the knee joint, head, and neck are the most affected). However, it can affect any organ, but it is very rare in the intrathoracic cavity. SS represents 14.7% of primary intrathoracic sarcomas, being the most common type of...
Findings and procedure details
The study consisted of 6 men and 6 women. The mean age of 46 years (range, 20–62 years). Five patients had pleural SS, three had pulmonary SS, two had mediastinal SS (including one intratracheal SS), and two were present in the thoracic wall (esternal-condral and thoracoabdominal wall). The results are tabulated in Table 1. [Table 1]
About the clinical presentation, the majority of the patients were symptomatic at presentation (11/12, 92%), with the most common presentation being dyspnea in 9/12 (75%), chest pain in 4/12...
Conclusion
The pleural pulmonary-based SS is the most common form of intrathoracic SS and is heterogeneously enhancing and most often solid-cystic at presentation.
Metastases are most commonly pleuro-pulmonary lesions, with similar radiological findings from the primary tumor.
Imaging plays an important role in establishing thoracic SS, although a definite diagnosis requires histopathological confirmation.
Personal information and conflict of interest
R. Pareja Maldonado:
Nothing to disclose
M. Flores Dueñas:
Nothing to disclose
A. M. Bonilla Ruiz:
Nothing to disclose
R. Cruz Baca:
Nothing to disclose
References
Baheti AD, Sewatkar R, Hornick JL, Saboo SS, Jagannathan JP, Ramaiya NH, Tirumani SH. Imaging features of primary and recurrent intrathoracic synovial sarcoma: a single-institute experience. Clin Imaging. 2015 Sep-Oct;39(5):803-8.
Lan, T., Chen, H., Xiong, B. et al. Primary pleuropulmonary and mediastinal synovial sarcoma: a clinicopathologic and molecular study of 26 genetically confirmed cases in the largest institution of southwest China. Diagn Pathol 11, 62 (2016).
Peter A, Kumar A, Kumar M, Patel V, Kumar V, Arya V, et al. Pulmonary synovial sarcoma: A case...