Primary pulmonary monophasic synovial sarcoma: Evading diagnosis

Area of Science:

• Oncology
• Pathology

Background:

• Primary pulmonary synovial sarcoma is an exceptionally rare thoracic malignancy.
• Optimal management strategies remain undefined due to its rarity.

Observation:

• A 78-year-old male presented with constitutional symptoms including weight loss and dyspnea.
• Radiological imaging revealed a significant right-sided lung mass with associated pleural effusion.
• Positron-emission tomography demonstrated intense 18F-fluorodeoxyglucose uptake in the mass.

Findings:

• Preoperative investigations and intraoperative frozen section analysis were inconclusive for definitive diagnosis.
• Postoperative immunohistochemistry and molecular profiling confirmed the presence of primary pulmonary monophasic synovial sarcoma.

Implications:

• This case underscores the diagnostic difficulties associated with rare pulmonary tumors.
• Advanced molecular techniques are crucial for accurate diagnosis when conventional methods fail.
• Establishing definitive diagnostic criteria is essential for guiding treatment decisions in pulmonary sarcomas.