Primary synovial sarcoma of the lung: a rare presentation, diagnostic dilemma and review of literature

2020 ◽  
Vol 13 (11) ◽  
pp. e237678
Author(s):  
Laxman Pandey ◽  
Deepa Joseph ◽  
Rajesh Pasricha ◽  
Manoj Kumar Gupta
Keyword(s):  
Synovial Sarcoma ◽  
Left Lung ◽  
Treatment Protocol ◽  
Rare Presentation ◽  
Diagnostic Dilemma ◽  
Rare Tumour ◽  
Improved Outcomes ◽  
Long Term Follow Up ◽  
Lung Metastasectomy ◽  
Malignant Lung Tumours

Primary synovial sarcoma of the lung (PSSL) is a rare tumour with only 0.5% incidence among other primary malignant lung tumours. Published medical literature regarding the natural history treatment protocol and clinical outcomes of PSSL remains limited. Here, we present a case of a 39-year-old man with primary synovial sarcoma with long-term follow-up, which was initially viewed as a metastasis from another unknown site. After evaluating histopathologically from the specimen post left lung metastasectomy and ruling out any other site for neoplastic changes, the diagnosis of PSSL was confirmed. Furthermore, this article reviews the literature and discusses various aspects of PSSL, including clinical presentation, radiological imaging and pathological characteristics, diagnostic dilemma, management and prognosis. This paper serves to provide an update and aims to enhance the understanding of PSSL. Timely diagnosis and treatment are imperative to achieve improved outcomes.

scholarly journals Transitional Cell Carcinoma in Pelvis of a Double Moiety Kidney- A Rare Presentation

2020 ◽  
Author(s):  
Debansu Sarkar ◽  
Bikram Haldar ◽  
Dilip Kumar Pal
Keyword(s):  
Transitional Cell Carcinoma ◽  
Cell Carcinoma ◽  
Stone Formation ◽  
Transitional Cell ◽  
Flexible Ureteroscopy ◽  
Pelvic Malignancy ◽  
Rare Presentation ◽  
Diagnostic Dilemma ◽  
Duplex Kidney ◽  
Long Term Follow Up

Neoplasia of the renal pelvis in duplex kidneys is extremely rare, especially in complete renal ureteral duplex cases. A 46-year-old aged male patient had presented with intermittent haematuria for the last seven months. A mildly enhancing well-defined, lobulated mass arising from the pelvis of lower moiety of right kidney was found on evaluation. Confirmatory findings of a renal pelvic malignancy couldn’t be obtained. Infective condition like pyelonephritis couldn’t be excluded. To clear the diagnostic dilemma, flexible ureteroscopy was done which revealed the renal pelvic malignancy. Right lap assisted radical nephroureterectomy was done. Histopathology was suggestive of transitional cell carcinoma. The increased incidence of chronic infection, obstruction and stone formation may be instrumental in producing a higher incidence of renal pelvic tumours in patients with anomalous kidney. Diagnosing a neoplasia originating from a duplex kidney is difficult and often a multiple battery of investigations like intravenous pyelogram, ultrasonography and rigid ureteroscopy may not be useful. Considering the fact that tumour recurrence is high in the ureteric stump after local resection, a total nephroureterectomy seems to be a better treatment choice. Flexible ureteroscope might be the saviour in such doubtful clinical situations to confirm our diagnosis beyond doubt. Partial nephrectomy cannot be recommended unless long-term follow-up reports of such cases are available.

The inhaled pin inaccessible to the bronchoscope: a management conundrum

2009 ◽  
Vol 123 (12) ◽  
pp. 1399-1401 ◽  
Author(s):  
D V T Harischandra ◽  
J Swanevelder ◽  
R K Firmin
Keyword(s):  
Open Surgery ◽  
Left Lung ◽  
Treatment Protocol ◽  
Emergency Unit ◽  
Combined Approach ◽  
Unique Challenge ◽  
Basal Segment ◽  
Accident And Emergency ◽  
Sharp Foreign Body

AbstractObjective:The inhaled sharp foreign body is usually amenable to bronchoscopic extraction. When this fails, management poses a challenge. We present a logical approach to the inhaled pin inaccessible to the bronchoscope.Case report:A 12-year-old girl presented to the accident and emergency unit after accidentally inhaling a pin. Multiple attempts with both rigid and flexible bronchoscopy failed to access the pin, which had lodged distally in the anteromedial basal segment of the left lung. Eventually, the pin was extracted at thoracotomy.Conclusion:We discuss the reasons for extracting such pins, as opposed to leaving them in situ, and when to proceed from endoscopy to open surgery. Such knowledge is useful, not only to guide the multidisciplinary team in their combined approach to this unique challenge, but also to explain to the patient the rationale for the proposed treatment protocol.

scholarly journals Benign Osteoblastoma Involving Maxilla: A Case Report and Review of the Literature

2012 ◽  
Vol 2012 ◽  
pp. 1-4 ◽  
Author(s):  
K. Bokhari ◽  
M. S. Hameed ◽  
M. Ajmal ◽  
Rafi A. Togoo
Keyword(s):  
Case Report ◽  
Surgical Excision ◽  
Good Prognosis ◽  
Histopathological Diagnosis ◽  
Diagnostic Challenge ◽  
Diagnostic Dilemma ◽  
Long Term Follow Up ◽  
Rare Benign Tumor ◽  
Benign Osteoblastoma ◽  
Maxilla And Mandible

Background. Osteoblastoma is a rare benign tumor. This tumor is characterized by osteoid and bone formation with the presence of numerous osteoblasts. The lesion is more frequently seen in long bones and rarely involves maxilla and mandible. Due to its clinical and histological similarity with other bone tumors such as osteoid osteoma and fibro-osseous lesions, osteoblastoma presents a diagnostic dilemma.Case Report. Very few cases of osteoblastomas involving maxillofacial region have been reported in the literature. This case report involves osteoblastoma involving right maxilla in an 18-year-old male patient. Following detailed clinical examination, radiological interpretation, and histopathological diagnosis, surgical excision was performed. The patient was followed up for a period of 3 years and was disease free.Summary and Conclusion. Benign osteoblastoma involving jaw bones is a rare tumor. There is a close resemblance of this tumor with other lesions such as fibro-osseous lesions and odontogenic tumors and thus faces a diagnostic challenge. Surgical excision with a long-term follow-up gives good prognosis to this lesion—Benign Osteoblastoma.

Acute proptosis secondary to bilateral pansinus mucopyocele with orbital compartment syndrome: a rare presentation, its management and outcome

2021 ◽  
Vol 14 (7) ◽  
pp. e241972
Author(s):  
Khushboo Chauhan ◽  
Tanya Sharma ◽  
Bhavana Sharma ◽  
Samendra Karkhur
Keyword(s):  
Compartment Syndrome ◽  
Nasal Polyposis ◽  
Signs And Symptoms ◽  
Sinus Surgery ◽  
Rare Presentation ◽  
Diagnostic Dilemma ◽  
Guided Exploration ◽  
Rapid Relief ◽  
Maxillary Sinuses

A 37-year-old Indian female presented with forward protrusion of left eye for one week, associated with progressive diminution of vision. The patient had undergone sinus surgery for nasal polyposis a year ago. On examination, there was severe proptosis and limitation of extraocular movements in all gazes. CT-scan revealed a heterogeneous expansile mass, arising from left fronto-ethmoidal sinus, infiltrating left orbit. MRI showed T2-hyperintense, peripherally enhancing areas in bilateral nasal cavity (right >left), bilateral ethmoidal sinuses and frontal, sphenoidal and maxillary sinuses. Otorhinolaryngology consultation was sought and in view of vision threatening proptosis — with likely orbital compartment syndrome — emergent endoscopic guided exploration and orbital decompression was undertaken. Rapid relief of signs and symptoms was achieved, with normal vision, extraocular movements and resolution of proptosis. Cytology and microbiology ruled out infectious or malignant aetiology and helped in resolving a diagnostic dilemma. Histopathology confirmed the diagnosis of mucopyocele and follow-up period was uneventful.

scholarly journals Synovial sarcoma: case report

2017 ◽  
Vol 65 (3) ◽  
pp. 260-264
Author(s):  
Isabella Lima Arrais RIBEIRO ◽  
Larissa Cavalcanti MONTEIRO ◽  
Ana Carolina Rodrigues de MELO ◽  
Tácio Candeia LYRA ◽  
Julio Cesar Campos FERREIRA FILHO ◽  
...  
Keyword(s):  
Tumor Growth ◽  
Synovial Sarcoma ◽  
Fibrous Tissue ◽  
Treatment Protocol ◽  
Neck Region ◽  
Cervical Region ◽  
Histopathological Analysis ◽  
Parotid Region ◽  
Synovial Sarcomas

ABSTRACT Introduction: Synovial sarcomas are rare and aggressive neoplasms located in the head and neck region and usually occurs in young adults. Presentation of case: This report presents a case of synovial sarcoma in a 15-year-old male patient who sought medical treatment for painful symptoms and associated dysphagia. The lesion was nodular, extensive, localized in the parotid region, and extended to the left cervical region. The patient was treated in a referral hospital with a treatment protocol that initially included chemotherapy for six months and surgery to attempt to excise the lesion, but the surgery was ineffective because removal could have damaged important vital structures. The Computed Tomography scan showed a hypodense area with diffuse growth and no involvement of the facial bones and the histopathological analysis revealed pleomorphic and oval spindle cells with rounded epithelial cells that formed nests surrounded by fibrous tissue. The Immunohistochemistry analysis was conclusive for the diagnosis of a high-grade SS in the parotid and left cervical regions. The medical team opted for palliative treatment with cervical radiotherapy. The patient remained hospitalized for four months after the surgery and died after 15 months since the diagnosis for compromise of airway by fast tumor growth. Conclusion: The synovial sarcoma, when diagnosed late may reduce the survival of patients because of the complications that tumor growth can bring to the prognosis and quality of life.

scholarly journals Haemangiopericytoma of the greater omentum: a rare tumour requiring long-term follow-up

2018 ◽  
Vol 2018 (5) ◽  
Author(s):  
Dionysia Vasdeki ◽  
Effrosyni Bompou ◽  
Alexandros Diamantis ◽  
Athanasios Anagnostou ◽  
Konstantinos Tepetes ◽  
...  
Keyword(s):  
Greater Omentum ◽  
Rare Tumour ◽  
Long Term Follow Up

scholarly journals Primary umbilical endometriosis – A rare presentation of cutaneous endometriosis

2021 ◽  
Vol 6 (3) ◽  
pp. 226-230
Author(s):  
Girija C ◽  
Muhammed Aslam K K
Keyword(s):  
Rare Condition ◽  
Surgical Excision ◽  
Rare Presentation ◽  
Surgical Biopsy ◽  
Diagnostic Dilemma ◽  
Child Bearing ◽  
Surgical Speciality ◽  
Cutaneous Endometriosis ◽  
Clinical Differential Diagnosis ◽  
Umbilical Endometriosis

Primary umbilical endometriosis is a rare condition with an overall incidence of around 0.5% to 1% among all the endometriosis cases, but at times it poses a diagnostic dilemma. In our institution we encountered a case of primary umbilical endometriosis presented to multiple surgical speciality departments. A prompt clinical examination with surgical biopsy was the key tool which lead to the diagnosis and providing a complete cure for the patient. Pelvic endometriosis affects 5-10% of women in the child bearing age group. The most pronounced symptoms are dyspareunia, pelvic pain, and infertility. Clinical presentations of umbilical endometriosis are as a nodule with or without associated umbilical pain and bleeding. This patient was given primary hormonal therapy and later underwent a biopsy which paved way for an accurate diagnosis of primary umbilical endometriosis. In this case of umbilical swelling, conditions like a benign nevus, lipoma, abscess, cyst, hernia, as well as metastatic deposit from a systemic malignancy were considered in the clinical differential diagnosis. However surgical excision helped us arrive at a definitive diagnosis and cure for the patient.

scholarly journals Synovial sarcoma presenting as subcutaneous swelling: a rare presentation

2019 ◽  
Vol 6 (6) ◽  
pp. 2190
Author(s):  
Dheer S. Kalwaniya ◽  
Jaspreet S. Bajwa
Keyword(s):  
Soft Tissue ◽  
Early Diagnosis ◽  
Knee Joint ◽  
Synovial Sarcoma ◽  
Lower Risk ◽  
Soft Tissue Sarcomas ◽  
Synovial Cells ◽  
Rare Presentation

Synovial sarcoma unlike its name is not originating from synovial cells. It accounts for approximately 10% of all soft tissue sarcomas with main predilection for extremities.We present here a case of synovial sarcoma of subcutaneous origin of knee joint which is rarest of presentations and early diagnosis is associated with lower risk of metastasis and hence better prognosis.

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