This case highlights the importance of recognizing primary mediastinal synovial sarcoma, a rare and aggressive neoplasm, which can be successfully managed with surgical resection and adjuvant chemotherapy.
Supports multimodal management in rare mediastinal synovial sarcoma; leaves open need for larger studies to guide practice.
INTRODUCTION: Synovial sarcomas commonly occur in the extremities of young adults. A primary occurrence in the mediastinum is very rare with only a few reported cases in the world literature. We report a case of mediastinal synovial sarcoma. This paper is about a 47-year-old male who presented with retrosternal chest pain and shortness of breath on exertion. Imaging showed an anterior mediastinal mass. Pathological examination of the resected mass showed a biphasic neoplasm with a spindle cell component admixed with gland-like elements. The tumor showed positive staining with cytokeratin, epithelial membrane antigen and vimentin confirming the diagnosis of a biphasic synovial sarcoma. DISCUSSION: A wide range of neoplasms, both primary and metastatic, occur in the mediastinum, which pose considerable diagnostic difficulties. A synovial sarcoma should always be considered in the differential diagnosis, and immunohistochemistry is an important adjuvant tool in this situation. CONCLUSION: This paper highlights the importance of recognizing an unusual presentation of this aggressive neoplasm to aid appropriate clinical management.
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Ershadi et al. (2016) studied this question.
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