CTICasesPrimary Pulmonary Synovial Sarcoma
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Imaging findings
CT angiogram shows a large, heterogeneous left intrathoracic mass compressing the lower lobe and displacing the mediastinum. The mass is compressing the left pulmonary artery and extensively invading the left main bronchus, extending up to the carina. Evidence of tumor extension into the central airways is present. Pathology confirmed synovial sarcoma with Ewing sarcoma rearrangement and trisomy in the tumor cells, indicating an aggressive nature.
Key takeaways
Primary lung sarcomas are rare but should be considered in young patients with large, aggressive intrathoracic masses, especially when showing features of local invasion. Synovial sarcoma is a highly aggressive tumor often characterized by specific genetic rearrangements and high mitotic rates, making surgical resection challenging due to extensive invasion.
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