Primary monophasic synovial sarcoma, a rare pulmonary mesenchymal neoplasm: report of a case with review of literature

A. Bhagya Lakshmi, K. Satya Sri, B. V. S. Kartheek, Nagarjun Rao


Synovial sarcoma is an uncommon malignant soft tissue tumour which occurs primarily in young adults. It most commonly occurs in the extremities near large joints, particularly the knee joint. Primary pulmonary synovial sarcoma has only occasionally been reported in the literature. We report a case of primary pulmonary monophasic synovial sarcoma in a 23 year old male patient presenting with recent onset of hemoptysis, cough and expectoration. Although an uncommon primary site, the characteristic histological and immunohistochemical features, and fluorescence in situ hybridization analysis for the characteristic (X;18) translocation, with thorough clinical and imaging correlation allowed a definitive diagnosis of primary pulmonary monophasic sarcoma. The mainstay of treatment for these unusual tumours remains complete surgical excision followed by adjuvant radiation and/or chemotherapy.


Monophasic synovial sarcoma, Lung, Immunohistochemistry

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Terasaki H, Niki T, Hasegawa T, Yamada T, Suzuki K, Kusumoto M, et al. Primary synovial sarcoma of lung. A case report confirmed by molecular detection of SYT-SSX Fusion gene transcripts. Jpn J Clin Oncol. 2001;31(5):212-6.

Rong Rong, Erika E. Doxtader, Jamie Tull, Gustavo de la Roza, Shengle Zhang. Metastatic poorly differentiated monophasic synovial sarcoma to lung with unknown primary: a molecular genetic analysis. Int J Clin Exp Pathol. 2010;3(2):217-21.

Alaa N. Alsharief, Musa Fageeh, Yousof Alabdulkarim. Monophasic synovial sarcoma presenting as a primary ileal mass: a case report and review of the literature. J Med Case Rep. 2012;6:83.

Kumar R, Menon S, Desai SB, Pramesh CS, Menon H, Jambhekar NA. Primary endobronchial synovial sarcoma confirmed by SYT-SSX1 fusion gene transcript by reverse transcriptase polymerase chain reaction. Indian J Pathol Microbiol. 2009;52:520-3.

Etienne-Mastroianni B, Falchero L, Chalabreysse L, Loire R, Ranchère D, Souquet PJ, et al. Primary sarcomas of the lung. A clinicopathologic study of 12 cases. Lung Cancer. 2002;38(3):283-9.

Kransdorf MJ. Malignant soft-tissue tumors in a large referral population: distribution of diagnoses by age, sex, and location. AJR Am J Roentgenol. 1995;164:129.

Herzog CE. Overview of sarcomas in the adolescent and young adult population. J Pediatr Hematol Oncol. 2005;27:215.

Burt M, Ihde JK, Hajdu SI, Smith JW, Bains MS, Downey R, et al. Primary sarcomas of the mediastinum: results of therapy. J Thorac Cardiovasc Surg. 1998;115:671-80.

Gaertner E, Zeren EJ, Fleming MV, Colby TV, Travis WD. Biphasic synovial sarcomas arising in the pleural cavity: a clinicopathological study of 5 cases. Am J Surg Pathol. 1996;20:36-45.

Sandberg AA, Bridge JA. Updates on the cytogenetics and molecular genetics of bone and soft tissue tumors. Synovial sarcoma. Cancer Genet Cytogenet. 2002;133:1.