Ahmet Tuncay TURGUT, Ugur KOŞAR, Cüneyt KURUL, Salih TOPÇU, İrfan TAŞTEPE

NADİR BİR TORAKS TÜMÖRÜ: SİNOVYAL SARKOM OLGU SUNUMU VE LİTERATÜRÜN GÖZDEN GEÇİRİLMESİ

Toraksın primer sinovyal sarkomu oldukça nadirdir. Akciğer, plevra veya göğüs duvarı tutulumu görülebildiğigibi bu bölgelerin birden fazlası da tutulabilir. Göğüs duvarında kitle saptanması nedeniyle opere edilen veoperasyon materyaline ait doku tanısı monofazik sinovyal sarkom olarak raporlanan, 55 yaşındaki erkek hastanınoperasyon öncesindeki PA akciğer grafisinde sağ hemitoraks alt zonda, diyafragmadan net olaraksınırlandırılamayan kitle görünümü izlendi. Toraks BT incelemesinde sağ akciğer orta lob komşuluğunda,plevraya geniş tabanla oturan, interkostal alanlardan göğüs duvarına uzanan, 97x72 mm boyutlarında düzgünsınırlı kitle saptandı. Tanımlanan görüntüleme bulguları özgül olmamakla birlikte, ayırıcı tanıda toraksın primermalign neoplazmları içerisinde nadir görülen sinovyal sarkom da göz önünde bulundurulmalıdır

Anahtar Kelimeler:

Sinovyal sarkom, toraks, radyografi, bilgisayarlı tomografi

A Rare Tumor of the Thorax: Synovial Sarcoma Case Report and Review of the Literature

Primary synovial sarcoma of the thorax is extremely rare. The involvement of lung, pleura or chest wall may be seen and sometimes more than one of these structures may be effected. The preoperative chest radiography of a 55-year-old male patient operated for a mass lesion detected on chest wall revealed a mass lesion at the inferior zone of the right hemithorax which was not discernible from the diaphragma. Thorax CT examination revealed a sharply marginated mass lesion with dimensions of 97x72 mm, located adjacent to the right middle lobe, having a wide pleural base and extending through the intercostal space to the chest wall. Rare synovial sarcoma of the thorax should be considered in the diferential diagnosis of the primary malignant neoplasms of the thorax, though the imaging findings are non-specific.

Keywords:

Synovial sarcoma, thorax, radiography, computed tomography,

PDF

___

1. Kransdorf MJ, Murphey MD. Synovial tumors. In: Kransdorf MJ, Murphey MD, editors. Imaging of Soft Tissue Tumors. Saunders, Philadelphia, 1997: 275- 316.
2. Tateishi U, Gladish GW, Kusumoto M, Hasegawa T, Yokoyama R, Tsuchiya R, Moriyama N. Chest wall tumors: radiologic findings and pathologic correlation: part 2. Malignant tumors. Radiographics 2003; 23:1491-508.
3. Duran-Mendicuti A, Costello P, Vargas SO. Primary synovial sarcoma of the chest: radiographic and clinicopathologic correlation. J Thorac Imaging 2003; 18: 87-93.
4. Jawahar DA, Vuletin JC, Gorecki P, Persechino F, Macera M, Magazeh P. Primary biphasic synovial sarcoma of the pleura. Respiratory Medicine 1997; 91: 568-70.
5. Dahnart W. Radiology review manual. 3rd ed. Williams&Wilkins, Baltimore, 1996:29-126.
6. Mukhopadhyay S, Aubry MC. Recurrent primary synovial sarcoma of the chest wall. J Thorac Oncol 2007; 2: 660-1.
7. Bui-Mansfield LT, Kaplan KJ, Bordman J. Synovial sarcoma of the chest wall.AJR 2002; 179: 880.
8. Nakajo M, Ohkubo K, Nandate T, Shirahama H, Yanagi M, Anraku M, Nakajo M. Primary synovial sarcoma of the sternum: computed tomography and magnetic resonance imaging findings. Radiat Med 2005; 23: 208-12.
9. Fujimoto K, Hashimoto S, Abe T, Meno S, Terasaki H, Nishimura H, Hayabuchi N. Synovial sarcoma arising from the chest wall: MR imaging findings. Radiat Med 1997;15:411-14.
10. Frazier AA, Franks TJ, Pugatch RD, Galvin JR.From the archives of the AFIP: Pleuropulmonary synovial sarcoma. Radiographics 2006; 26: 923-40.
11. Gaertner E, Zeren EH, Fleming MV, Colby TV, Travis WD. Biphasic synovial sarcomas arising in the pleural cavity: a clinicopathologic study of five cases. Am J Surg Pathol 1996; 20: 3645.
12. Aubry MC, Bridge JA, Wickert R, Tazelaar HD. Primary monophasic synovial sarcoma of the pleura: five cases confirmed by the presence of SYT-SSX fusion transcript.Am J Surg Pathol 2001; 25: 77681.
13. Slone RM, Gierada DS. Pleura, chest wall, and diaphragm. In: Lee JK, Sagel SS, Stanley RJ, Heiken JP, editors. Computed body tomography with MRI correlation 3rd ed. Lippincott-Raven, Philadelphia, 1998: 455-520.
14. Jeung MY, GangiA, Gasser B, Vasilescu C, Massard G, Wihlm JM, Roy C. Imaging of chest wall disorders. Radiographics 1999; 19: 617-37.