Case report-Primary synovial sarcoma of lung

Primary synovial sarcoma of lung is an extremely rare tumor. The etiology and pathogenesis of sarcomas, like those of most cancers, are not well understood. A definitive diagnosis requires detailed radiological imaging, immunohistochemical staining and molecular genetics techniques. Histologically it was classified in to monophasic and biphasic synovial sarcoma. We reported a case of primary synovial sarcoma of lung presenting with hoarseness of voice, left side chest pain cough and fever. Contrast enhanced computer tomography revealed a large homogeneous mass, occupying most of the left hemi thorax. Ultrasound (US) guided fine needle aspiration cytology (FNAC) of lung revealed synovial sarcoma-monophasic type. Immunohistochemistry (IHC) analysis revealed positive for bcl-2 and CD-99. Even though surgical management is the primary option followed by chemotherapy/radiation therapy, due to patient factors we were planned for neoadjuvent chemotherapy with 3 cycles of Ifosphamide plus Adriamycin. Treatment response shows no response and progressive disease and furtherely patient was referred to surgical management.