Posterior mediastinal biphasic synovial sarcoma in a 12 year-old boy: A case report and review of literature

Abstract

We report a case of biphasic synovial sarcoma of the mediastinum, a very rare tumor, in a 12-year-old boy with left-sided chest pain of 3 years duration at presentation. Chest X-ray showed left-sided opacity with loss of cardiac silhouette and the mediastinum deviated to the opposite side. Computed tomography (CT) of thorax showed left-sided posterior mediastinal mass with left-sided pleural effusion and pleural thickening. CT guided fine needle aspiration cytology (FNAC) from the mass reported it as spindle cell variant of adenocarcinoma. Ultrasonography (USG) of the whole abdomen revealed no abnormality. The mediastinal tumor was resected by left thoracotomy and histopathological report confirmed it to be a biphasic synovial sarcoma with capsule invasion at places.

Giant primary synovial sarcoma of the anterior mediastinum: A case report and review of literature

“…They make up 5-10% of all soft-tissue sarcomas, and arise mainly in the extremities of young adults, in second to fourth decades of life and between 15 and 40 years of age. [3,4] Synovial sarcomas also arise in joint cavities and anywhere unassociated with a joint cavity such as the head and neck, lower back, abdominal wall, genitourinary tract, thoracic wall, and intrathoracic and other much rarer sites. [5] They can also present as a primary mediastinal neoplasm, with a morphologic appearance similar to those occurring in the extremities.…”

Primary giant mediastinal synovial sarcoma of the neck: A case report and review of the literature

“…The following treatments have been applied for synovial sarcomas: i) Although mediastinal synovial sarcomas have limited clinical data and no standardized treatments, complete surgical excision remains the cornerstone of therapy (5,6,8,9). A broad surgical excision must be promoted for inchoate patients, as presented in the current case report where the patient’s tumor and left innominate vein and phrenic nerve were resected in hope of increased disease-free survival.…”

“…In the current case report, a large tumor was found in the mediastinum prior to surgery, and a small mass shadow remained visible in the follow-up CT scan following surgery. After referring to specific mediastinal synovial sarcoma treatments available overseas (6,9), the patient was treated with adjuvant post-operative radiotherapy with a total of 64 Gy, in the hope of controlling local recurrence. iii) Chemotherapy is an additional, predominant tool used for tumor treatments and is particularly important for preventing tumors from distant metastasis.…”

“…The mass was significantly reduced following 6 cycles of neoadjuvant chemotherapy (ifosfamide and doxorubicin) followed by radical en bloc resection, and the patient exhibited no signs of disease recurrence following five years of routine follow-up examinations. The therapeutic regimen of ifosfamide and doxorubicin has been regularly used for the treatment of synovial sarcomas to prolong overall survival rates (6,7,9,17). The patient in the present case report also accepted 4 cycles of this combination regimen and the follow-up CT scans (Fig.…”

Sarcoma synoviale

“…Legritkábban retroperitonealisan (0,8-8,3%) hasi fájdalom vagy érzékeny hasi terime képével jelentkezik [20]. A szervezet bármely régiójában kialakulhat (pajzsmirigy [21], gingiva [22], nyelv [23], mediastinum [24], elülső hasfal [25], vese [26], mellék-vese [27], nyelőcső, cardia, gyomor, proximalis és distalis duodenum, jejunum, ileum, colon [28] és női genitá-liák [29]). MR-vizsgálattal az SS környezetétől élesen elhatároló-dó, nagymértékben cisztikus megjelenést mutat, 20-30%-ban tartalmaz kalcifikációt [30].…”