Radiological assessment following thermoradiation therapy for primary pleural synovial sarcoma: case report

A case report of primary pleural synovial sarcoma, an uncommon etiology of a thoracic parietal mass

INTRODUCTION AND IMPORTANCE

Synovial sarcomas are aggressive soft tissue malignancies. Damage to the chest wall is uncommon and rarely seen.

CASE PRESENTATION

We are reporting an observation of a patient who presented with chest pain and a parietal tumor. Radiological investigations have identified pleural thickening as an extension outside the chest wall. The mass biopsy guided by the scan revealed a synovial sarcoma. The patient underwent a thorough tumor removal surgery with complex postoperative management for hypoxemic pneumopathy.

CLINICAL DISCUSSION

The efficacy of a comprehensive treatment strategy combining surgery, chemotherapy, and radiotherapy for invasive malignancies is still unclear, with total tumor excision being essential. Experts often recommend adjuvant radiation therapy, but the importance of chemotherapy is multifaceted.

CONCLUSION

We emphasize the rarity of chest localization for these tumors, their unique clinical presentation, and the various therapeutic approaches.

Synovial sarcoma leading to a paraesophageal abscess in a child

Background:

Synovial sarcoma (SS) is an uncommon malignant neoplasm arising from primitive pluripotential mesenchyme primarily affecting the soft tissues of the extremities. Rarely other locations are involved, including the mediastinum.

Case Report:

After treatment for mediastinal SS by surgical resection, radiation therapy, and chemotherapy, an 11-year-old boy developed an esophageal stricture and fistula, the latter resulting in a paraesophageal abscess. Management of the esophageal stricture and fistula required a multi-disciplinary approach. We report our experience with the management of this difficult complication, as well as a brief review of the literature on SS.

Conclusions:

Rare conditions, particularly those with unusual complications, present therapeutic challenges requiring a multi-disciplinary team approach. Reporting experiences with difficult cases can benefit providers faced with similar problems in the future.