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Case Report
Unexpected intruder: A rare case of mediastinal synovial sarcoma
1 Consultant Medical Oncologist, Department of Medical Oncology, MOC Cancer Care & Research Centre, Pune, India
2 MD, DM, Senior Consultant, Department of Medical Oncology, Omega Hospitals, Hyderabad, India
3 MD, DM, Senior Consultant and Head, Department of Medical Oncology, Omega Hospitals, Hyderabad, India
4 DNB, Senior Consultant and Head, Department of Pathology, Omega Hospitals, Hyderabad, India
5 Medical Writer, Department of Clinical Research, MOC Cancer Care & Research Centre, Mumbai, India
Address correspondence to:
Siddhesh Tryambake
Consultant Medical Oncologist, MOC Cancer Care & Research Centre, Pune,
India
Message to Corresponding Author
Article ID: 100150Z10ST2025
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How to cite this article
Tryambake S, Vasini V, Nirni SS, Kumari C, Morzaria D, Wategaonkar R. Unexpected intruder: A rare case of mediastinal synovial sarcoma. J Case Rep Images Oncology 2025;11(2):15–19.ABSTRACT
Introduction: Synovial sarcomas frequently manifest in the extremities of young people. A primary incidence in the mediastinum is exceedingly rare, with just a limited number of cases documented in global literature. We present a case of mediastinal synovial sarcoma.
Case Report: This report discusses a 37-year-old male who exhibited retrosternal chest discomfort and dyspnea with exertion. Imaging revealed an anterior mediastinal mass. The pathological examination of the excised mass revealed a monophasic tumor characterized by spindle cells possessing elongated oval hyperchromatic nuclei and mild eosinophilic cytoplasm. The tumor had strong staining for TLE-1 and vimentin, validating the diagnosis of monophasic synovial sarcoma.
Conclusion: The mediastinum encompasses a heterogeneous group of neoplasms, including both primary and metastatic, often posing significant diagnostic challenges. Synovial sarcoma, although uncommon in this location, should remain a key consideration in the differential diagnosis, and immunohistochemistry serves as an essential technique in this context. This case highlights the importance of recognizing this rare and aggressive tumor to guide appropriate diagnostic and optimize therapeutic decision making.
Keywords: Adjuvant chemotherapy, Immunohistochemistry, Mediastinal synovial sarcoma, Monophasic spindle cell tumor, SYT-SSX fusion
SUPPORTING INFORMATION
Author Contributions
Siddhesh Tryambake - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Vindhya Vasini - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
SS Nirni - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Interpretation of data, Final approval of the version to be published
Chaitanya Kumari - Substantial contributions to conception and design, Acquisition of data, Interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published
Disha Morzaria - Interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published
Ravi Wategaonkar - Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Guaranter of SubmissionThe corresponding author is the guarantor of submission.
Source of SupportNone
Consent StatementWritten informed consent was obtained from the patient for publication of this article.
Data AvailabilityAll relevant data are within the paper and its Supporting Information files.
Conflict of InterestAuthors declare no conflict of interest.
Copyright© 2025 Siddhesh Tryambake et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.
