Spontaneous Regression Of Primary Pulmonary Synovial Sarcoma
Tsunezuka, H., Miyata, N., Furuya, T., Konishi, E., & Inoue, M. (2018). Spontaneous Regression of Primary Pulmonary Synovial Sarcoma. The Annals of thoracic surgery, 105(3), e129–e131. https://doi.org/10.1016/j.athoracsur.2017.09.008
View Original Source →Abstract
We report a rare case of primary pulmonary synovial sarcoma that underwent spontaneous regression after a transbronchial biopsy. A 38-year-old woman with a well-demarcated solitary mass shadow on chest roentgenogram was referred to us. A transbronchial biopsy was performed, and immunohistochemical results as well as detection of SYT-SSX1 (SYnovial sarcoma Translocation-Synovial Sarcoma X chromosome breakpoint) transcripts resulted in a diagnosis of synovial sarcoma. A right lower lobectomy was performed during video-assisted thoracoscopic surgery. Pathologic examination revealed widespread coagulative necrosis with feeding arterioles occluded by organized thrombi. To our knowledge, this is the first report of a case of spontaneous regression of primary pulmonary synovial sarcoma.
Case Details
Disease Location
Lung
Personal Characteristics
38-year-old woman. Diagnosis of behcet disease
Clinical Characteristics
She presented with a well-demarcated solitary tumor shadow in the right lower lobe, very close to the diaphragm. A contrast-enhanced chest computed tomography scan obtained the day before a transbronchial biopsy was performed revealed a 3.8-cm heterogeneous growing tumor mass in the right lower field of the lung. A positron emission tomography scan showed accumulation along only the periphery of the tumor 1 month after the transbronchial biopsy. Analysis of the transbronchial biopsy specimen revealed that the lesion was composed of sheets of spindle cells with plump nuclei and no necrosis. Immunohistochemically, the spindle tumor cells were diffusely positive for bcl2 (b-cell lymphoma 2) and tle- 1 (transducin-like enhancer protein 1) a right lower lobectomy with systematic lymph node dissection was performed during video-assisted thoracoscopic surgery 2 months after the transbronchial biopsy. A pulmonary tumor was observed
Remission Characteristics
Pathologic examination of a specimen retrieved from lymph node dissection revealed cytoreduction of 1.1 cm in diameter and widespread coagulative necrosis, with peripheral granulation and feeding arterioles occluded by organized thrombi
Treatment & Mechanisms
Proposed Remission Mechanisms
Induction of an immunologic response by biopsy
Clinical Treatment
Biopsy lymph node dissection
Non-Clinical Treatment
None reported