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. Diagnosed with behcet disease
Clinical Characteristics
Presented with a well-demarcated solitary tumor shadow in the right lower lobe, very close to the diaphragm. Transbronchial biopsy revealed a 3.8-cm heterogeneous growing tumor mass in the right lower field of the lung. Immunohistochemically, the spindle tumor cells were diffusely positive for bcl2, and tle- 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 at the posterobasal segment of the lower lobe.
Remission Characteristics
Pathologic examination revealed cytoreduction of 1.1 cm diameter and widespread coagulative necrosis, with peripheral granulation and feeding arterioles occluded by organized thrombi
Treatment & Mechanisms
Proposed Remission Mechanisms
Vascular endothelial damage caused by the transbronchial biopsy triggered thrombotic occlusion in the arterioles.
Clinical Treatment
Biopsy