Pericardial synovial sarcoma presenting with unstable angina

Abstract

A 43-year-old man had an incidental finding of a large anterior mediastinal mass. He suddenly presented with unstable angina and an emergency coronary angiogram showed severe proximal circumflex artery and left anterior descending artery stenosis from external compression. He underwent emergency coronary artery bypass graft surgery and excision of the tumor. At surgery, the tumor was found to be invading the left ventricle, so debulking of the mediastinal tumor was performed. Histology showed a biphasic pericardial synovial sarcoma. The patient was recommended chemotherapy and radiotherapy but he refused. He died 13 months after surgery.

Right atrial synovial sarcoma with thrombocytopenia: A deceptive presentation

“…These tumors are often greater than 5 cm in diameter with the pericardium being the most common location. Other locations include the RA, left atrium, tricuspid valve, right ventricle, left ventricle, mitral valve, and pulmonary valve sequentially 4 …”

“…(B) Image showing tricuspid annulus after the removal of the tumor mass. LA, left atrium; LV, left ventricle; RA, right atrium; RV, right ventricle include the RA, left atrium, tricuspid valve, right ventricle, left ventricle, mitral valve, and pulmonary valve sequentially 4.…”

Multimodal imaging features of primary pericardial synovial sarcoma: a case report

“…Although the tumor did recur later, the patient survived for 17 months, which is significantly longer than the mean survival length of 6 months reported in the literature (17).…”

Primary Pericardial Synovial Sarcoma: A Case Report and Literature Review

“…There are a few distinct features in our case when compared to the literature review: first, the lack of invasive aspects—in spite of an aggressive histological subtype of the primary tumor, the mass appeared well defined, encapsulated and occupying only the pericardium, sparing cardiac cavities and blood vessels; second, despite the fact that the primary tumor was very large, the patient survived three times the mean survival length of 6 months compared with the literature reports [ 13 ]; third, the pericardial mass was depicted also on echocardiography and last, this is the first reported contralateral aggressive relapse.…”

“… * US = echocardiography; SI = signal intensity; N/A = not reported; References [ 6 , 8 , 12 , 13 , 14 , 15 , 16 , 17 ]. …”