A Case of Primary Synovial Sarcoma of the Posterior Mediastinum with Aortic Wall Infiltration with Complete Imaging Pathway and Histological Diagnosis

Graphical-abstract
Danilo Caudo, Alessandro Santalco, Carmelo Anfuso, Ylenia Zullo, Alessandra Pelle, Caterina Benedetto, Annalisa
Militi, Viviane Di Dio, Fabio Italiano, Ugo Barbaro
Abstract

Primary synovial mediastinal sarcomas are aggressive tumors with a very rare incidence. The few cases reported in the literature presented poor and incomplete imaging. In this report, we describe the case of a 72-year-old male patient
hospitalized for dyspnoea and chest tightness. For these reasons, he underwent chest X-ray, contrast-enhanced CT, MRI, and PET, which revealed a large mass around the aortic walls. The patient underwent a CT-guided biopsy and the subsequent histopathological evaluation indicated features consistent with a soft tissue sarcoma and positive staining for vimentin. Infiltration of aorta walls was confirmed by an MRI study with cine-MRI sequences. The patient was treated with neoadjuvant chemotherapy, showing partial response. Unfortunately, during the following attempted surgical removal of the mediastinal mass, the patient deceased as a result of an aorta rupture. Our experience could help in diagnostic confidence and differential diagnosis, especially with benign tumors such as neurogenic
tumors.

Published on: May 31, 2022
doi: 10.17756/micr.2022-075
Citation: Caudo D, Santalco A, Anfuso C, Zullo Y, Pelle A, et al. 2022. A Case of Primary Synovial Sarcoma of the Posterior Mediastinum with Aortic Wall Infiltration with Complete Imaging Pathway and Histological Diagnosis. J Med Imaging Case Rep 6(1): 16-21.

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