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Lung

, Volume 192, Issue 1, pp 211–214 | Cite as

Primary Pulmonary Synovial Sarcoma: A Rare Primary Pulmonary Tumor

  • Roger Fei Falkenstern-Ge
  • Martin Kimmich
  • Andreas Grabner
  • Heike Horn
  • Godehard Friedel
  • German Ott
  • Martin Kohlhäufl
Article

Abstract

Introduction

Pulmonary sarcomas overall are very uncommon and comprise only 0.5 % of all primary lung malignancies. The diagnosis is established only after sarcoma-like primary lung malignancies and a metastatic extrathoracic sarcoma have been excluded. Synovial sarcoma accounts for ~8 % of soft-tissue sarcomas. Synovial sarcoma arising from the pleura has rarely been reported.

Methods

We report a case of a 58-year-old woman who complained of right-sided chest pain and shortness of breath. Chest CT scan revealed a large heterogeneous mass, occupying most of the right hemithorax. Histologic diagnosis was supplemented by interphase cytogenetic (FISH) analysis.

Results

Computed tomography guided Tru-cut biopsy was suspicious for a sarcomatous or fibrous malignancy. However, intraoperative frozen-section diagnostics confirmed the diagnosis of a sarcoma. Immunohistochemistry showed that tumor cells expressed epithelial membrane antigen, CD99 and BCL2. Based on immunohistochemistry, the diagnosis of synovial sarcoma was suspected and was confirmed by FISH analysis. The patient was treated with right upper bilobectomy. Due to R1-resection status, postsurgical systemic chemotherapy was administered.

Conclusions

Primary pulmonary synovial sarcoma is a rare primary lung tumor. Due to extensive size of the tumor with pleural and mediastinal invasion only a R1-resection status could be achieved by thoracic surgery.

Keywords

Immunohistochemistry Lung mass Primary pulmonary synovial sarcoma 

Notes

Conflict of interest

The author(s) indicated no potential conflicts of interest.

References

  1. 1.
    Suurmeijer et al. (2013) Synovial sarcoma. In: Fletcher DM et al. (eds) WHO classification of tumors of soft tissue and bone, 4th edn. IARC, LyonGoogle Scholar
  2. 2.
    Okamoto S, Hisaoka M, Daa T, Hatakeyama K, Iwamasa T, Hashimoto HA et al. (2004) Primary pulmonary synovial sarcoma: a clinicopathologic, immunohistochemical, and molecular study of 11 cases. Hum Pathol 35:850–856CrossRefPubMedGoogle Scholar
  3. 3.
    Essary LR, Vargas SO, Fletcher CD (2002) Primary pleuropulmonary synovial sarcoma: reappraisal of a recently described anatomic subset. Cancer 94:459–469CrossRefPubMedGoogle Scholar
  4. 4.
    Etienne-Mastroianni B, Falchero L, Chalabreysse L, Loire R, Ranchere D, Souquet PJ et al. (2002) Primary sarcomas of the lung: a clinicopathologic study of 12 cases. Lung Cancer 38:283–289CrossRefPubMedGoogle Scholar
  5. 5.
    Kumar R, Menon S, Desai SB, Pramesh CS, Menon H, Jambhekar NA (2009) Primary endobronchial synovial sarcoma confirmed by SYT-SSX1 fusion gene transcript by reverse transcriptase polymerase chain reaction. Indian J Pathol Microbiol 52:520–523CrossRefPubMedGoogle Scholar
  6. 6.
    Dennison S, Weppler E, Giacoppe G (2004) Primary pulmonary synovial sarcoma: a case report and review of current diagnostic and therapeutic standards. Oncologist 9:339–342CrossRefPubMedGoogle Scholar
  7. 7.
    Alcaraz-García P, Díaz-Palacios S, Castillo-Canto C, Gatica-Pérez A, Sánchez-González JA (2012) Primary pulmonary biphasic synovial sarcoma: a case report and literature review. Cir Cir 80(1):67–71PubMedGoogle Scholar
  8. 8.
    Trassard M, Le Doussal V, Hacene K, Terrier P, Ranchère D, Guillou L et al. (2001) Prognostic factors in localized primary synovial sarcoma: a multicenter study of 128 adult patients. J Clin Oncol 19:525–534PubMedGoogle Scholar
  9. 9.
    Miser JS, Kinsella TJ, Τriche TJ et al. (1987) Ifosfamide with mesna uroprotection and etoposide: an effective regimen in the treatment of recurrent sarcomas and other tumors of children and young adults. J Clin Oncol 5:1191–1198PubMedGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  • Roger Fei Falkenstern-Ge
    • 1
  • Martin Kimmich
    • 1
  • Andreas Grabner
    • 2
  • Heike Horn
    • 3
  • Godehard Friedel
    • 4
  • German Ott
    • 2
  • Martin Kohlhäufl
    • 1
  1. 1.Division of Pulmonology, Klinik Schillerhoehe, Center for Pulmonology and Thoracic SurgeryTeaching Hospital of the University of TuebingenStuttgart-GerlingenGermany
  2. 2.Department of Clinical Pathology, Robert Bosch KrankenhausTeaching Hospital of the University of TuebingenStuttgartGermany
  3. 3.Dr. Margarete Fischer-Bosch Institute of Clinical Pharmacology IKPStuttgartGermany
  4. 4.Division of Thoracic Surgery, Klinik Schillerhoehe, Center for Pulmonology and Thoracic SurgeryTeaching Hospital of the University of TuebingenStuttgart-GerlingenGermany

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