Primary Pleural Synovial Sarcoma With Metastatic Cardiac Involvement: A Case Report

Primary pleuropulmonary synovial sarcomas are rare soft tissue malignancies; combined metastatic involvement of the heart is extremely rare. In this case report, a 17-year-old female presented with a history of chest pain. Chest radiographs revealed a round mass in the left upper hemithorax, and computed tomography (CT) showed a well-defined heterogeneous enhancing mass abutting the pleura. A core needle biopsy revealed malignant spindle cells. Surgical resection was performed, and a final diagnosis of primary pleural synovial sarcoma, monophasic fibrous type, was made. The patient underwent radical irradiation and chemotherapy and remained stable for 28 months until a follow-up chest CT showed a poorly enhancing nodule in the left pericardial region that enlarged after 5 months. Surgical resection was performed. Histological examination confirmed metastatic cardiac involvement from a primary pleural synovial sarcoma. We report this unusual case of a primary pleural synovial sarcoma metastasis to the heart.