A Case report: Synovial sarcoma of the mediastinum in an 18-year-old teenager

TL;DR

A rare case of synovial sarcoma in the chest of a teenager is reported, diagnosed through imaging and lab tests, and successfully treated with surgery and therapy.

Contribution

This case report highlights a rare presentation of synovial sarcoma in the mediastinum and its successful management.

Findings

Synovial sarcoma was diagnosed in an 18-year-old with a mediastinal mass using CT, immunohistochemistry, and FISH.

The tumor compressed the trachea and invaded nearby vessels, but treatment improved symptoms.

Combining imaging and lab results helped distinguish synovial sarcoma from other mediastinal tumors.

Abstract

Synovial sarcomas (SSs) are a rare group of malignant tumors originating from pluripotential mesenchymal cells, which commonly occur as the primary tumor in the soft tissues near the articular surface, tendons, and articular synovium. Herein, we report a rare case of mediastinal SS in an 18-year-old teenager who initially presented with cough as the primary symptom. In this case, plain chest CT and contrast-enhanced CT clearly revealed the lesion presenting as a round-like and uneven density mass in the mediastinum with heterogeneous enhancement, which compressed the trachea and invaded the adjacent vessels. Based on the results of immunohistochemistry and fluorescence in situ hybridization (FISH), combined with the differential diagnosis with other types of tumors in the mediastinum on imaging, we were able to diagnose the tumor as an SS located in the mediastinum. Subsequent resection of the lesion coupled with chemotherapy and immunotherapy led to an improvement in the patient’s symptoms.

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