Multidisciplinary management of recurrent synovial sarcoma of the chest wall

Santiago A Endara; Juan S De la Torre; Fernando J Terán; Juan Pablo Alarcón; Carla E Tovar

doi:10.1016/j.xnsj.2023.100243

Multidisciplinary management of recurrent synovial sarcoma of the chest wall

N Am Spine Soc J. 2023 Jul 21:15:100243. doi: 10.1016/j.xnsj.2023.100243. eCollection 2023 Sep.

Authors

Santiago A Endara¹, Juan S De la Torre², Fernando J Terán³, Juan Pablo Alarcón⁴, Carla E Tovar⁵

Affiliations

¹ Cardiovascular and Thoracic surgeon, Hospital Metropolitano, Quito, Ecuador.
² Spine Surgeon, Hospital Metropolitano, Quito, Ecuador.
³ Orthopedic surgery senior resident, Universidad Internacional del Ecuador, Quito, Ecuador.
⁴ General Surgery resident, Universidad Internacional del Ecuador, Quito, Ecuador.
⁵ Oncologist surgeon, Hospital Metropolitano. Quito, Ecuador.

Abstract

Background: Synovial sarcoma (SS) is part of soft tissue sarcomas (STS). An incidence between 5% to 10% is estimated. The origin is mesenchymal mainly affecting the extremities. Being even rarer at the chest level and vertebral body, representing around 1%. Histologically, it consists of 3 variants: monophasic, biphasic, and poorly differentiated. Surgical resection is a priority when it comes to multidisciplinary management. The prognosis of patients with SS over the years has improved markedly.

Purpose: Understand and evaluate the multidisciplinary management of SS considering that the SS has a lowe prevalence and highly malignancy.

Study design: We present a case of a 31-year-old male who has a history of monophasic synovial sarcoma diagnosed in 2019 and underwent surgery. Patient came back after two years without symptoms and posterior to a control MRI we observed a local recurrence of SS.

Methods: The literature was reviewed with a focus on best clinical and surgical strategy for recurrence of SS.

Results: The patient recovered well with return to his normal daily activities. The review of the literature shows us the importance of the multidisciplinary management for the optimal clinical and surgical approach of SS recurrence.

Conclusions: SS represents a unique variant of STS, with malignant and metastatic potential. Being a rare pathology, an adequate multidisciplinary management is essential when providing optimal care for the patient.

Keywords: Adjuvant therapies; Local recurrence; Multidisciplinary management; Synovial sarcoma.

Publication types

Case Reports