Delayed neoadjuvant therapeutic response in rare giant pulmonary tumor: A case report

Area of Science:

• Oncology
• Thoracic Surgery
• Medical Oncology

Background:

• Primary pulmonary synovial sarcoma (PPSS) is an extremely rare intrathoracic soft tissue sarcoma.
• There is a significant lack of established consensus guidelines for the diagnosis and treatment of PPSS.
• This rarity poses challenges for effective patient management and clinical decision-making.

Observation:

• A case of a 35-year-old patient diagnosed with PPSS was reported.
• The patient underwent neoadjuvant chemotherapy involving adriamycin, ifosfamide, and anlotinib, a multi-target tyrosine kinase inhibitor.
• Initial response assessment to the neoadjuvant therapy was not encouraging.

Findings:

• Despite initial discouraging response assessment, subsequent imaging studies revealed significant therapeutic efficacy of the neoadjuvant regimen.
• The combination therapy, including the tyrosine kinase inhibitor anlotinib, showed a positive impact on the PPSS tumor.
• This case highlights the potential benefit of neoadjuvant chemotherapy in managing rare thoracic sarcomas.

Implications:

• This case underscores the critical role of a multidisciplinary team approach in the management of PPSS.
• Neoadjuvant therapy, including novel agents like anlotinib, may be a viable strategy for PPSS.
• Raising awareness of this rare malignancy is crucial for improving diagnostic and therapeutic outcomes.