Akshay D Baheti1, Rani Sewatkar2, Jason L Hornick3, Sachin S Saboo4, Jyothi P Jagannathan5, Nikhil H Ramaiya5, Sree Harsha Tirumani5. 1. Department of Imaging, Dana-Farber Cancer Institute, Harvard Medical School, 450 Brookline Ave, Boston, MA 02215; Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, 75 Francis Street, Boston, MA 02115. Electronic address: akshaybaheti@gmail.com. 2. Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, 75 Francis Street, Boston, MA 02115. 3. Department of Pathology, Brigham and Women's Hospital, Harvard Medical School, 75 Francis Street, Boston, MA 02115. 4. Department of Imaging, Dana-Farber Cancer Institute, Harvard Medical School, 450 Brookline Ave, Boston, MA 02215; Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, 75 Francis Street, Boston, MA 02115; Department of Radiology, University of Texas Southwestern Medical Center, Dallas, TX. 5. Department of Imaging, Dana-Farber Cancer Institute, Harvard Medical School, 450 Brookline Ave, Boston, MA 02215; Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, 75 Francis Street, Boston, MA 02115.
Abstract
OBJECTIVE: The objective was to study the imaging features of primary and metastatic intrathoracic synovial sarcoma (ISS). MATERIALS AND METHODS: We reviewed the imaging of 42 patients with ISS (31 pleural, 7 intrapulmonary, 4 mediastinal), with baseline imaging of 19 patients and follow-up imaging in all. RESULTS: Primary tumors (n=19) were well circumscribed (15/19), homogeneous or heterogeneously enhancing, with mean size 9.1 cm (range: 1.8-25 cm). Recurrent/metastatic disease developed in 28/42 patients (67%). Lung was the most common site of metastases (21/28), with most of them predominantly pleural (11/21). On pathology, 30 patients had monophasic tumors, and 6 each had biphasic tumors and poorly differentiated tumors. CONCLUSION: Intrathoracic SS most commonly presents as a large heterogeneous pleural mass without associated adenopathy. Lung metastases are often pleural based and ipsilateral.
OBJECTIVE: The objective was to study the imaging features of primary and metastatic intrathoracic synovial sarcoma (ISS). MATERIALS AND METHODS: We reviewed the imaging of 42 patients with ISS (31 pleural, 7 intrapulmonary, 4 mediastinal), with baseline imaging of 19 patients and follow-up imaging in all. RESULTS:Primary tumors (n=19) were well circumscribed (15/19), homogeneous or heterogeneously enhancing, with mean size 9.1 cm (range: 1.8-25 cm). Recurrent/metastatic disease developed in 28/42 patients (67%). Lung was the most common site of metastases (21/28), with most of them predominantly pleural (11/21). On pathology, 30 patients had monophasic tumors, and 6 each had biphasic tumors and poorly differentiated tumors. CONCLUSION: Intrathoracic SS most commonly presents as a large heterogeneous pleural mass without associated adenopathy. Lung metastases are often pleural based and ipsilateral.