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Vol.46 No.4 contents | Japanese/English |
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- Case Report -
Pleuropneumonectomy for Intrathoracic Metastases of a Synovial Sarcoma
Masaomi Yamane1, Hiroya Maeda1, Nobuki Nanki2, Mitsumasa Kaji3, Yasufumi Yamaji21Department of Thoracic Surgery, 2Department of Respiratory Medicine, 3Department of Radiology, Mitoyo General Hospital, Japan
Background. It is widely accepted that metastatic pulmonary tumors from synovial sarcoma can be resected with a curative intent. To the best of our knowledge, a pleuropneumonectomy for pulmonary metastases with dissemination from synovial sarcoma has never been reported. Case. A 26-year-old woman who had undergone extensive resection for synovial sarcoma in the right thigh suffered left back pain. Although she was treated with rehabilitation and medication, the pain persisted. Abdominal ultrasonography revealed a huge intrathoracic mass on the right diaphragm. A chest computed tomography (CT) showed multiple masses occupying the left side of the thoracic cavity. A needle biopsy confirmed the diagnosis of metastases from synovial sarcoma. After combined chemotherapy with adriacin and ifosfamide, a pleuropneumonectomy was carried out to remove all metastases. The pericardium and a diaphragm were partially resected because of the invasion. Histological findings confirmed the diagnosis of metastases from synovial sarcoma and invasion to the surface of the pericardium and diaphragm. There was no evidence of pulmonary metastasis within the histological investigation. The postoperative course was satisfactory and she was discharged from the hospital on the 8th postoperative day. She was then treated with an additional chemotherapy with 2 cycles of the same regimen. Six months postoperatively, multiple nodules were found in the right lung on a chest CT scan. She was treated with chemotherapy and has been doing well with remaining disease for 1 year after the surgery. Conclusion. Our experience suggested that pleuropneumonectomy for disseminated metastatic disease contribute to the quality of life and prolonged survival.
key words: Synovial sarcoma, Intrathoracic dissemination, Pleuropneumonectomy
Received: March 20, 2006
Accepted: May 2, 2006
JJLC 46 (4): 363-367, 2006
