Primary Pulmonary Synovial Sarcoma (PPSS): A Rare Case Report on Diagnosis and Management
Farisa T A
Department of Pharmacy Practice, St Joseph's College of Pharmacy, Cherthala, Kerala, India.
Telma Titto
Department of Pharmacy Practice, St Joseph's College of Pharmacy, Cherthala, Kerala, India.
Siby Joseph *
Department of Pharmacy Practice, St Joseph's College of Pharmacy, Cherthala, Kerala, India.
Madhu C S
Department of Oncology, Lourdes Hospital and Post Graduate Research Centre, Cochin, Kerala, India.
Aditya V Boney
Department of Oncology, Lourdes Hospital and Post Graduate Research Centre, Cochin, Kerala, India.
*Author to whom correspondence should be addressed.
Abstract
Primary pulmonary synovial sarcoma is a rare and distinct entity, comprising 0.5% of all primary lung malignancies. It typically manifests clinically with cough, chest pain, shortness of breath, or hemoptysis, and a mass lesion may be visible on X-ray or CT scan. Diagnosis is established through histopathology and immunohistochemistry. Here, we present a case of a 71-year-old male who exhibited cough with mucoid expectoration for 1 month, accompanied by breathing difficulties, weight loss, and evening rise of temperature, and the CT appearance consistent with advanced central bronchogenic carcinoma right middle lobe region infiltrating right hilar structure with endobronchial tumor extension and pericardial infiltation and small mediastinal lymphadenopathy. Right endobronchial mass biopsy suggest diagnosis of synovial sarcoma.Bronchoalveolar lavage from right bronchus for cytology showed scattered bronchial epithelial cells, lymphocytes, neutrophils and alveolar macrophages. Bronchial brushings for cytology positive for malignant cells.
Keywords: Primary pulmonary synovial sarcoma, synovial sarcoma, surgical resection, chemotherapy, histopathology