[Assessment of prognostic factors of thoracic synovial sarcoma].
BACKGROUND
Synovial sarcoma is an uncommon tumour and thoracic involvement is rare and of varying location. Clinical characteristics are dominated by pain, with a slow progression over years. Pathological and immuno-histochemical characteristics are helpful in the diagnosis but a specific translocation between chromosomes X and 18 is crucial for confirmation. Extensive surgical resection is required for cure, combined with adjuvant radiotherapy in the presence of adverse prognostic factors.


METHODS
We report a case of synovial sarcoma of the chest wall, responsible for chronic local pain for several years, presenting as an acute pleuropneumonitis in a 21-year-old patient. In view of the large size of the tumour, associated with a high proliferation index (Ki-67), a surgical resection was performed, together with local adjuvant radiotherapy.


CONCLUSIONS
This case report reviews synovial sarcoma and underlines the difficulties and requirements of both diagnostic strategy and therapeutic management. Among them, an initial systematic review of prognostic factors (tumour size, mitotic activity, proliferation index, SYT-SSX type fusion, histological grade) is crucial to determine the therapeutic options.
Service de pneumologie, bâtiment 5F, centre hospitalier Lyon-Sud, Hospices Civils de Lyon, 165, chemin du Grand-Revoyet, 69495 Pierre-Bénite cedex, France; Université Claude-Bernard, 69008 Lyon, France.
B H Mbatchou
BH
Ngahane
H
H
Baudrand
A
A
Traverse-Glehen
N
N
Freymond
B
B
Guibert
Y
Y
Pacheco
G
G
Devouassoux
D014408:Biomarkers, Tumor / Q000032:analysis; D003131:Combined Modality Therapy; D003937:Diagnosis, Differential; D005500:Follow-Up Studies; D006801:Humans; D008197:Lymph Node Excision; D008279:Magnetic Resonance Imaging; D008297:Male; D009361:Neoplasm Invasiveness; D011001:Pleuropneumonia / Q000175:diagnosis / Q000473:pathology; D011013:Pneumonectomy; D011379:Prognosis; D018714:Radiotherapy, Adjuvant; D013584:Sarcoma, Synovial / Q000175:diagnosis* / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery; D012907:Smoking / Q000009:adverse effects; D013899:Thoracic Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery; D035441:Thoracic Wall / Q000473:pathology / Q000601:surgery; D013908:Thoracotomy; D055815:Young Adult
D014408:Biomarkers, Tumor