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A Rare Primary Synovial Sarcoma of Lung - Case Report with Literature Review

Arun RD

Primary synovial sarcoma of lung is an extremely rare tumor. The etiology and pathogenesis of sarcomas lung are not well understood. A definitive diagnosis requires detailed radiological imaging, immunohistochemical staining and molecular genetics techniques. Histologically it was classified in to monophasic and biphasic synovial sarcoma. We reported a case of primary synovial sarcoma of lung presenting with hoarseness of voice, left side chest pain, cough and fever. Contrast enhanced computer tomography revealed a large homogeneous mass, occupying most of the left hemi thorax. Ultrasound (US) guided fine needle aspiration cytology (FNAC) of lung revealed synovial sarcoma-monophasic type. Immunohistochemistry (IHC) analysis revealed positive for bcl-2 and CD-99. Hence it was a complete left lung obstruction with Eastern Cooperative Oncology Group (ECOG) score of 3. Eventhough Surgical management is the primary option, due to high risk and poor performance score we have planned for 3 cycles of chemotherapy (Ifosphamide plus Adriamycin). Treatment response shows no response and progressive disease and furtherely trearted with supportive care.