Primary synovial sarcoma of the pericardium diagnosed after multiple biopsies following recurrent episodes of haemorrhagic pericardial effusion following infection: a case report

This case highlights the diagnostic difficulty of primary pericardial synovial sarcoma. Initial biopsy may be falsely negative, and repeated sampling directly from the lesion is crucial when a cardiac tumour is suspected. Furthermore, ¹⁸F-FDG PET/CT proved valuable not only for diagnostic assessment but also for therapeutic monitoring. In summary, repeated targeted biopsy and multimodality imaging are essential for accurate diagnosis and management of this rare cardiac malignancy.