Giant primary synovial sarcoma of the anterior mediastinum: A case report and review of literature

Primary synovial sarcoma is a very rare tumor of the mediastinum, which is unreported in the entire subcontinent of West Africa, and presents daunting challenges from diagnosis to management with lack of standard management strategies. We present a case of primary monophasic synovial sarcoma of the anterior mediastinum, in a 22-year-old Nigerian lady who presented with cough, chest pain, and pleural effusion. Chest X-ray (CXR) and computed tomography on admission showed a left-sided huge mass in the left anterior mediastinum with no metastasis to the contralateral pleural cavity. Complete resection of the mediastinal tumor was done and histologic and immunohistochemical analyses confirmed a diagnosis of monophasic synovial sarcoma. However, 10 months postoperation she represented with chest pain, productive cough and a repeat CXR showed multiple left pulmonary nodules. She received two cycles of docetaxel and gemcitabine chemotherapy, but declined further treatment until her demise 8 months later.