primary pleural synovial sarcoma with metastatic cardiac involvement: a case report

primary pleuropulmonary synovial sarcomas are rare soft tissue malignancies; combined metastatic involvement of the heart is extremely rare. in this case report, a 17-year-old female presented with a history of chest pain. chest radiographs revealed a round mass in the left upper hemithorax, and computed tomography (ct) showed a well-defined heterogeneous enhancing mass abutting the pleura. a core needle biopsy revealed malignant spindle cells. surgical resection was performed, and a final diagnosis of primary pleural synovial sarcoma, monophasic fibrous type, was made. the patient underwent radical irradiation and chemotherapy and remained stable for 28 months until a follow-up chest ct showed a poorly enhancing nodule in the left pericardial region that enlarged after 5 months. surgical resection was performed. histological examination confirmed metastatic cardiac involvement from a primary pleural synovial sarcoma. we report this unusual case of a primary pleural synovial sarcoma metastasis to the heart.