Rare Case of Mediastinal Synovial Sarcoma in an Indonesian Woman

Abstract

Background: Synovial sarcoma mediastinum is a rare tumor, with a few cases having been reported. Case Presentation: A 27-year-old Indonesian woman had a complaint of shortness of breath and left chest pain. Chest X-ray showed a massive pleural effusion with reddish-yellow pleural fluid. Thorax CT scan showed a clear demarcated mass in the anterior mediastinum until left medius, with value of lactic acid dehydrogenase of 561 U/L. The patient was diagnosed with mediastinal tumor and performed left anterolateral thoracotomy with tumor weight of 2.354 mg. Tumor histopathology consisted of positive Vimentin, BCL2 and CD99 antibodies. The patient performed 3 cycles of chemotherapy after surgery using doxorubicin, ifosfamide, and mesna. Post-chemotherapy results of CT showed metastases in the left hemidiaphragm with an expansion of mass defects and lymphadenopathy in the upper right paratracheal. Conclusion: The prognosis synovial sarcoma mediastinum is worse than synovial sarcoma in other organs as seen in most recurrent cases.

A rare case of a young man with mediastinal synovial sarcoma

“…Hemorrhagic cystitis can occur with ifosfamide chemotherapy. Adequate fluid hydration and additional mesna therapy based on the patient's weight can help reduce these side effects [ 16 ].…”