title: Occult primary pulmonary synovial sarcoma presenting as recurrent spontaneous pneumothorax and explosive progression.
abstract: Primary pulmonary synovial sarcoma (PPSS) is a relatively rare neoplasm with highly progressive potential. We present an extremely rare case of PPSS presenting as recurrent pneumothorax with bullous lesions. Bullectomy was performed at the local hospital. Unfortunately, the patient was initially misdiagnosed as atypical carcinoid. Although a negative resection margin was obtained during the first surgery and a remedial operation and chemotherapy followed, the patient developed severe disease progression and died soon after. This report demonstrates that PPSS can easily be misdiagnosed and should be seriously considered in the differential diagnosis of pneumothorax.
authors.affiliation: Department of Thoracic Surgery, West China Hospital, Western China Collaborative Innovation Center for Early Diagnosis and Multidisciplinary Therapy of Lung Cancer, Sichuan University, Chengdu, China.
authors.forename: Chenglin
authors.initials: C
authors.lastname: Guo
authors.affiliation: Department of Thoracic Surgery, West China Hospital, Western China Collaborative Innovation Center for Early Diagnosis and Multidisciplinary Therapy of Lung Cancer, Sichuan University, Chengdu, China.
authors.forename: Chengwu
authors.initials: C
authors.lastname: Liu
authors.affiliation: Department of Thoracic Surgery, West China Hospital, Western China Collaborative Innovation Center for Early Diagnosis and Multidisciplinary Therapy of Lung Cancer, Sichuan University, Chengdu, China.
authors.forename: Qiang
authors.initials: Q
authors.lastname: Pu
authors.affiliation: Department of Thoracic Surgery, West China Hospital, Western China Collaborative Innovation Center for Early Diagnosis and Multidisciplinary Therapy of Lung Cancer, Sichuan University, Chengdu, China.
authors.forename: Feng
authors.initials: F
authors.lastname: Lin
authors.affiliation: Department of Thoracic Surgery, West China Hospital, Western China Collaborative Innovation Center for Early Diagnosis and Multidisciplinary Therapy of Lung Cancer, Sichuan University, Chengdu, China.
authors.forename: Lunxu
authors.initials: L
authors.lastname: Liu
mesh_terms: D000328:Adult; D003937:Diagnosis, Differential; D018450:Disease Progression; D017809:Fatal Outcome; D006801:Humans; D008175:Lung Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D008297:Male; D011030:Pneumothorax / Q000209:etiology* / Q000601:surgery; D013584:Sarcoma, Synovial / Q000000981:diagnostic imaging* / Q000473:pathology; D014057:Tomography, X-Ray Computed
keywords: 
  Pneumothorax; pulmonary; synovial sarcoma