Neoadjuvant chemotherapy followed by complete resection with extrapleural pneumonectomy may be an effective treatment strategy for primary pleural synovial sarcoma.
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May support neoadjuvant chemotherapy plus extrapleural pneumonectomy in primary pleural synovial sarcoma; hypothesis-generating and should not yet change practice.
We describe a rare case of primary pleural synovial sarcoma in a 27-year-old man with a 4-month history of dry cough and left-sided chest pain. A CT scan showed a large cystic mass in the left pleural cavity. The patient underwent two video-assisted thoracoscopic biopsies and the diagnosis of synovial sarcoma of the pleura was established. After neoadjuvant chemotherapy, which resulted in a partial response, the tumor was completely resected with extrapleural pneumonectomy. Pathological findings showed less than 5% of viable cancer and free surgical margins. The patient is clinically well 24 months after surgery, with no evidence of recurrent disease.
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Silva et al. (2010) studied this question.
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