A Case of Metastatic Synovial Sarcoma of the Lung With Recurrent Spontaneous Pneumothorax.

BACKGROUND: Synovial sarcoma, a highly aggressive soft tissue sarcoma, is mostly seen among young people and tends to occur in the extremities. It most commonly metastasizes to the lungs, and symptoms such as chest tightness, shortness of breath, and coughing are common after metastasis. However, multiple spontaneous pneumothorax is relatively rare. This article aims to further enhance the understanding of synovial sarcoma by introducing a case of pulmonary metastasis after surgery for synovial sarcoma originating from the sole of the foot and reviewing relevant literature.

CASE: The Cardiothoracic Surgery Department of the Northeast Yunnan Central Hospital Region admitted a 40-year-old male patient. He had previously undergone surgery for synovial sarcoma on the left foot dorsum. Seven years after the surgery, the patient experienced two spontaneous pneumothorax events. A chest CT scan revealed solid nodules in the upper lobe of the left lung. Our department performed surgical removal, and pathology confirmed metastatic pulmonary synovial sarcoma. After the surgery, the patient's symptoms improved significantly, and there were no further pneumothorax attacks. The patient was then transferred to the oncology department for further treatment to improve prognosis.

CONCLUSION: Pulmonary metastasis of synovial sarcoma is not uncommon, and a considerable number of patients are found to have no surgical opportunity when diagnosed. In this case, the patient presented with a single solid nodule, and we adopted surgery as the first-line treatment, combined with a comprehensive treatment plan of postoperative chemotherapy to further improve the patient's prognosis.