Surgical treatment of primary synovial lung sarcoma: a case report

Synovial sarcoma is a rare aggressive malignant mesenchymal tumor that accounts for 2.5–10.0% of all sarcomas and is most often found in the soft tissues of the extremities, especially near large joints. Primary synovial lung sarcoma is quite rare and accounts for 0.5% of all primary malignant lung neoplasms. The tumor is sensitive to chemotherapy, but the main method of treatment of synovial lung sarcoma remains surgical. Publications devoted to this topic, are presented by clinical observations due to the rare occurrence of the disease, therefore, each such observation is of scientific and practical interest.

We present a clinical case 65-year-old patient with a tumor of the right lung with a diameter of more than 25 cm. Repeated attempts to perform transthoracic puncture both in our department and in other hospitals for the biopsy were unsuccessful. Taking into account the progression of the disease, the appearance and increase of the respiratory failure clinic, the impossibility to exclude the malignant nature of the process and the good functional status of the patient, a decision for surgery was made. The patient underwent right pneumonectomy with mediastinal lymph node dissection. The postoperative period was complicated by intrapleural bleeding, for which a rethoracotomy was performed. After recovery, the patient was discharged from the hospital in a stable condition.