Long-term survival after multiple synovial sarcoma lung-metastasis resections

Abstract

A 45-year-old female had a synovial sarcoma located in the left femoral region resected a year before being admitted due to lung metastases. After the first pulmonary resection, due to repeated pulmonary metastases five more resections were performed over a ten-year period. After having six complete resections, yet another metastasis was detected in the left main bronchus. Since, for this metastasis a left pneumonectomy was necessary to be able to do a complete resection, endobronchial laser therapy followed by chemotherapy was selected in order to avoid a left pneumonectomy. The patient was doing well nine months after chemotherapy, although she had residual tumor. Lung metastasis is a significant prognostic factor for synovial sarcoma. It is essential to treat lung metastasis by complete resection while preserving as much pulmonary parenchyma as possible. However, therapies other than surgery should be considered especially when pneumonectomy is contraindicated due to limited pulmonary reserve or when surgery would be difficult to do due to the presence of pleural adhesions related to previous thoracotomies.