Case Report


The surprising outcome of a giant primary mediastinal synovial sarcoma treated with neoadjuvant chemotherapy

Marcos Alexandre Balieiro, Agnaldo José Lopes, Bruno Pinheiro Costa, Gustavo Perissé Moreira Veras, Paulo Sergio Perelson, Rodolfo Acatauassú Nunes, Eduardo Haruo Saito

Abstract

There are only a few cases of primary mediastinal synovial sarcoma in the literature. Normally, they do not respond well to chemotherapy. In our case, a 30-year-old patient was admitted due to thoracic pain, dyspnea, orthopnea, cough, hoarseness and weight loss over a 3-month period as well as a dramatic worsening a week before the admission. A chest radiography showed a completely white left hemithorax and contralateral mediastinal shift; in addition, a chest tomography revealed a giant heterogeneous mediastinal mass, lung atelectasia and a small pleural effusion. The patient was submitted to Chamberlain procedure (biopsy) under local anesthesia and the diagnosis of a synovial sarcoma was obtained after immunohistochemical analysis. Due to his poor general condition, he received chemotherapy first, with a dramatic response, after what, the mass that had been reduced was removed surgically. After a 5-year- follow-up period there are no signs of disease recurrence.

Download Citation