2023 World Conference on Lung Cancer (Posters)-EP14.03. Rare but Aggressive: A Case of Primary Pulmonary Synovial Sarcoma

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This presentation discusses a rare case of primary pulmonary synovial sarcoma, a highly aggressive and rare malignant neoplasm. The patient, a 58-year-old never-smoker, presented with symptoms of cough, pleuritic pain, and hemoptysis. Imaging revealed a necrotic mass in the left lower lobe of the lung, as well as lymphadenopathy and pleural effusion. Further investigation confirmed a high-grade synovial sarcoma. The patient was treated with doxorubicin/ifosfamide chemotherapy, which was complicated by febrile neutropenia and a large tension pneumothorax with pleural empyema. The treatment plan includes a lobectomy, possibly with decortication, and consideration of adjuvant radiotherapy.<br /><br />Primary pulmonary sarcomas, including synovial sarcoma, are extremely rare, accounting for less than 0.5% of all pulmonary malignancies. These tumors arise from the pluripotent mesenchymal cells of the lung. Diagnosis is typically achieved through bronchoscopic biopsy. The optimal management of primary pulmonary synovial sarcoma is not well-established, but early resection followed by chemoradiation is generally recommended. The tumor type is relatively chemosensitive and responds well to Adriamycin (doxorubicin) alone or in combination with ifosfamide.<br /><br />The prognosis for patients with synovial sarcoma depends on various factors, including tumor grade, disease stage, age, gender, tumor size, and mitotic activity. Overall 5-year survival is approximately 50%. Early recognition of this rare malignancy is crucial for optimizing patient care.<br /><br />In summary, this case report highlights the challenges and treatment considerations for primary pulmonary synovial sarcoma. The rarity and aggressive nature of this tumor underscore the importance of early diagnosis and a multidisciplinary approach to treatment.

Asset Subtitle

Jennifer Duke

Meta Tag

Speaker Jennifer Duke

Topic Other Thoracic Malignancy

Keywords

primary pulmonary synovial sarcoma

malignant neoplasm

never-smoker

cough

pleuritic pain

hemoptysis

necrotic mass

lymphadenopathy

chemoradiation

early diagnosis