A Case of Primary Pulmonary Synovial Sarcoma

Abstract

The case involved a 58-year-old woman who had been on hemodialysis due to diabetic nephropathy. A plain chest X ray examination pointed out a mass image in the left lung. The size of the mass increased with time, and she was referred to our department. We performed partial resection of the lung by using thoracoscope, without gaining definitive diagnosis. A synovial sarcoma was suspected by postoperative pathological examination, and split signal was detected in more than 50% of the neoplastic cells by the close inspection by the FISH method using the SS18 probe. Combined with other findings, a single phase type synovial sarcoma was diagnosed. We judged it to be primary in the lung, because otherwise normal even in the orthopedic examinations after the definitive diagnosis. She is now alive without having recurrence in the whole body after four years from the surgery. Primary pulmonary synovial sarcoma is very rare, and few clinical experiences have not clarified the features of the disease. It is reported that about half of the patients die of this disease and the prognosis is poor. We need enough follow-up studies and the accumulation of cases, because no effective chemotherapies have been established as yet.