Recurrent pulmonary synovial sarcoma effectively treated with amrubicin: A case report

Area of Science:

• Oncology
• Pathology
• Medical Case Reports

Background:

• Pulmonary synovial sarcoma is a rare and aggressive thoracic malignancy.
• Accurate diagnosis can be challenging due to potential for misinterpretation of immunohistochemical markers.
• Synaptophysin and CD56 positivity can lead to misdiagnosis as small cell lung cancer.

Purpose of the Study:

• To report a case of pulmonary synovial sarcoma.
• To highlight diagnostic challenges and the effectiveness of third-line amrubicin (AMR) therapy.
• To investigate the potential chemosensitivity of pulmonary synovial sarcoma to AMR.

Main Methods:

• Case presentation of a 68-year-old female with pulmonary synovial sarcoma.
• Review of initial misdiagnosis and treatment for small cell lung cancer.
• Evaluation of response to platinum-based chemotherapy and subsequent amrubicin (AMR) monotherapy.
• Confirmation of diagnosis using fluorescence in situ hybridization (FISH) for SS18 split-signal.

Main Results:

• The patient was initially misdiagnosed and received ineffective platinum-containing chemotherapies.
• Third-line amrubicin (AMR) monotherapy resulted in a partial response, allowing daily life for 13 months.
• Fluorescence in situ hybridization confirmed the diagnosis of monophasic synovial sarcoma.
• This case represents the first documented successful treatment of pulmonary synovial sarcoma with AMR.

Conclusions:

• Pulmonary synovial sarcoma can be misdiagnosed based on initial immunohistochemistry.
• Amrubicin (AMR) monotherapy demonstrated significant efficacy in this rare case.
• This finding suggests a potential specific chemosensitivity of pulmonary synovial sarcoma to AMR, warranting further investigation.