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

Abstract

Synovial sarcomas commonly occur in the soft tissue of the extremities, while a primary occurrence in the mediastinum is quite rare. The current study reports the case of an 11-year-old male who presented with a neck mass, which computed tomography showed was due to a giant mediastinal mass involving the thyroid gland. The tumor was resected by thoracotomy and diagnosed as monophasic synovial sarcoma by histopathology. The patient received adjuvant combination chemotherapy and radiation therapy following surgery. At the 3-month follow-up, no local tumor recurrence was found. The present case report highlights the significance of recognizing the unusual presentation and clinical manifestation of synovial sarcoma to aid clinical management. Written informed consent was obtained from the patient’s family.

Primary synovial sarcoma of the mediastinum: a poor prognosis in a 14‐year‐old girl

“…Synovial sarcoma is a mesenchymal tissue tumour with epithelial differentiation, which occurs most frequently in extremities and is widespread among adolescents and young adults aged 15-40 years [2]. Primary synovial sarcoma is a malignant tumour with no specific differences from other mediastinal tumours in terms of clinical and imaging features, so it is difficult to diagnose.…”

“…Synovial sarcoma is a mesenchymal tissue tumour with epithelial differentiation, which occurs most frequently in extremities and is widespread among adolescents and young adults aged 15–40 years [ 2 ].…”

“…Thoracic localization is rare and mediastinal localization is exceptional [ 1 ]. Primary mediastinal synovial sarcomas are tumours with low incidence, no specific clinical manifestations, and lack of unified and effective treatments [ 2 ]. We report a case of synovial sarcoma in a young girl admitted to our thoracic surgery department with emphasis on imaging, the means of diagnosis, and the importance of the speed of therapeutic management.…”

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

“…Synovial sarcomas, particularly mediastinal synovial sarcomas, are highly aggressive tumors, which are more likely to invade adjacent significant organs, including the heart, lung, and blood vessels, the majority of which exhibit no evident clinical features, thus highlighting challenges for diagnosis and prompt treatment. [10] Mediastinal synovial sarcoma is a rare tumor with few cases reported world over but with no case of such a rare tumor having been reported in the West African subcontinent found in the available literature. [3,[5][6][7][8]10,11] The reason for this could be that, it is either rarer in West Africa or is under reported because of the unavailability of diagnostic facilities.…”

“…Patients with complete or repeated resections have been shown to have a better chance for long-term survival of up to 14 years. [10] Different oncologists have also used adjuvant chemotherapy and radiotherapy after either surgical resection or as neo-adjuvant therapy to reduce size of tumor, especially in unresectable diseases. However, most cases progressed locally and at distant sites shortly following completion of radiotherapy and chemotherapy and died within 2 years of diagnosis.…”