Primary Pleural Synovial Sarcoma: A Rare Cause of Hemorrhagic Pleural Effusion

Abstract

Primary pleural synovial sarcoma (PPSS) is a rare malignant pleural tumor comprising < 1% of all primary lung malignancies. Primary pleural mesothelioma (PPM) has many similar features that may cause a diagnostic dilemma due to overlapping clinical and histopathological features. We present the case of a young male with recurrent hemorrhagic pleural effusion without any obvious lung mass who was diagnosed with PPSS. This rare entity must be considered with a high index of suspicion while evaluating pleural tumors.

Whole‐exome sequencing in primary pulmonary synovial sarcoma misdiagnosed as mesothelioma: A case report and literature review

“…SS grows in four modes: poorly differentiated monophasic subtype, biphasic, monophasic fibrous (spindle cell), and monophasic epithelial 23,31 . The monophasic type comprises entirely fusiform cells with few cytoplasm, in which a deeply stained nucleus, round, oval, or short fusiform, without obvious division, can be found.…”

“…In general, patients may benefit from postoperative adjuvant or neoadjuvant chemotherapy, although the evidence so far is largely inconclusive 49 . Radiofrequency ablation can be used as an alternative therapy for nonoperative patients 31 . Through sequential multimode therapy, including surgery, radiosurgery, eribulin, and pazopanib, the survival time of patients can be relatively prolonged 11 .…”

“…30 SS grows in four modes: poorly differentiated monophasic subtype, biphasic, monophasic fibrous (spindle cell), and monophasic epithelial. 23,31 The monophasic type comprises entirely fusiform cells with few cytoplasm, in which a deeply stained nucleus, round, oval, or short fusiform, without obvious division, can be found. A series of morphological features such as interstitial mucinous degeneration, cystic degeneration, ossification, and angiopericytoma are more common in SS.…”

“…49 Radiofrequency ablation can be used as an alternative therapy for nonoperative patients. 31 Through sequential multimode therapy, including surgery, radiosurgery, eribulin, and pazopanib, the survival time of patients can be relatively prolonged. 11 Prazopanib is a potent and selective multitarget receptor tyrosine kinase inhibitor that blocks tumor growth and inhibits angiogenesis.…”

Extensive surgical resections for rare pleural neoplasms: A single-center experience with a yolk sac tumor and synovial sarcoma.

“…Pleural sarcomas are rare and aggressive tumors, accounting for less than 1% of all primary pulmonary malignancies. (17) The rst case of a pleural synovial sarcoma was published in 1996 by Gaertner et al…”