Unveiling the rare and giant: A case of primary synovial sarcoma of pluera

Background: Synovial sarcoma is a mesenchymal malignant spindle cell neoplasm. It most often occurs in the soft tissue of the extremities (lower around ankle, knee). Most pleural synovial sarcomas are metastatic. Primary synovial sarcoma of the pleura and lungs is extremely rare. Most frequently misdiagnosed as malignant mesothelioma. Case presentation: 55year-old female with a large synovial sarcoma of the right pleura. Patient presented with shortness of breath since 3 months duration. Chest x ray lateral view shows homogenous radio opacity with lobulated anterior margin extending from anterior mediastinum to posterior. Chest computed tomography (CT) revealed a 11 x 10.5 x 12.1cm large, well-defined, lobulated, pleuralbased solid lesion noted in the right hemithorax. Image guided biopsydone. Diagnosed as undifferentiated spindle cell sarcoma. She underwent right anterolateral thoracotomy and resection of tumour. The resected specimen contained a 13x 11x 8cm tumour diagnosed as biphasic synovial sarcoma based on its morphologic and immunohistochemical features. Advised Patient adjuvant radiation and chemotherapy. Conclusion: We presenting our experience of a large synovial sarcoma of the pleura in a patient with severe dyspnoea. She underwent right anterolateral thoracotomy and resection of tumour. Although the best treatment for this rare condition has not been defined, tumour resection and adjuvant therapy were able to decrease recurrence and increase in overall survival.