Primary pulmonary synovial sarcoma: a case report of unusual occurrence and review of literature

Synovial sarcoma (SS) is a highly malignant tumor that occurs mainly in adolescents and young adults and is usually seen in the extremities. However, primary SS arising from the lung is extremely rare, accounting for only 0.5% of cases. A young girl of age 3 years presented with 1 month history of fever associated with shortness of breath and significant weight loss. Computerized tomography and magnetic resonance imaging thorax show a large heterogeneous mass lesion in the left hemithorax from which ultrasonography-guided Tru-cut biopsy was done. Histopathology and immuno histo chemistry (IHC) followed by fine needle aspiration and imprint smear cytology further confirmed the diagnosis. The final diagnosis of primary pulmonary synovial sarcoma was made after ruling out other sites of metastatic involvement by 18 Fluorodeoxyglucose-positron emission tomography imaging. Surgical resection is the treatment of choice, if not possible, palliative chemotherapy can be given. Overall prognosis is very poor. Early diagnosis and intervention can improve outcome of this rare disease entity.