A case of primary pulmonary synovial sarcoma

TL;DR

A rare case of primary pulmonary synovial sarcoma in a 46-year-old woman was diagnosed after imaging suggested a benign tumor, highlighting the need for histopathology in accurate diagnosis.

Contribution

This case report adds to the limited literature on primary pulmonary synovial sarcoma and emphasizes the diagnostic challenges associated with it.

Findings

PPSS was diagnosed in a patient initially suspected of having a benign lung nodule based on low FDG uptake on PET imaging.

Surgical resection with clear margins led to a recurrence-free status for over one year.

The case underscores the importance of histopathological confirmation for accurate diagnosis of PPSS.

Abstract

Primary pulmonary synovial sarcoma (PPSS) is an extremely rare pulmonary malignancy and often poses diagnostic challenges, especially in differentiating it from benign tumors.

A 46-year-old woman presented with a slowly enlarging, well-defined nodule in the right lower lobe of the lung. Positron emission tomography showed low FDG uptake (SUVmax 1.52), raising suspicion for a benign lesion. However, histopathologic examination following wedge resection revealed primary pulmonary synovial sarcoma. Subsequently, a right lower lobectomy was performed. The patient has remained recurrence-free for over one year.

Surgical resection with clear margins is essential in the management of PPSS. This case highlights the difficulty in distinguishing PPSS from benign lung lesions based on imaging alone, underscoring the importance of pathological confirmation. Accumulation of more reported cases is needed to develop standardized treatment strategies.

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