Cardiac Synovial Sarcoma, Case Report

Yıl 2009, Cilt: 1 Sayı: 1, 57 - 59, 01.04.2009

Ahmet Midi Rahmi Çubuk Sıla Altınel Alpay Örki Yeşim Önder Yüksel Yurdugül Bülent Arman Gülçin Kıyan Orhan Türken

Öz

Cardiac synovial sarcoma is a rarely-seen tumor. A 37-years old male patient was operated in an external health center due to a right atrioventricular mass and was diagnosed as synovial sarcoma. Five months later, radiological examinations revealed a nodular mass lesion, 222x160x129 mm in size; in the left hemi-thorax that switches thoracic aorta and oesophagus on thorax CT. Plentiful nodules harmonious with metastasis the biggest of which is 18mm in diameter have been seen in the right lung. In his MR, a lobule-contoured,45x35 mm sized tumor that shows a protrusion on the level of tricuspic valve towards the right venticular lumen has been observed. The mass in his left hemithorax was removed by means of thoracotomy. In the microscopic examination of the operation material, at certain areas a cellular tumor made up of spindle cells in storiform pattern and whose borders were not clear and that usually showed an irregular structure has been spotted. At times, areas low in cellularity that showed myxoid change was observed. Cardiac synoval sarcoma due to its rarity in this area and its difficulty in diagnosis has been found worth presenting.

Anahtar Kelimeler

Synovial sarcoma, heart, tumour

Kardiak Sinovyal Sarkom, Olgu Sunumu

Öz

Kardiak sinovyal sarkom nadir görülen bir tümördür. Otuz yedi taşında erkek hasta sağ atrioventriküler kitle nedeniyle dış merkezde opere olmuş ve sinovyal sarkom tanısı almıştır. Beş ay sonraki radyolojik incelemelerinde; toraks BT'de sol hemitoraksta 222x160x129 mm ölçülerinde torasik aortayı ve özofagusu deplese eden kitlesel lezyon izlenmiştir. Sağ akciğerde en büyüğü 18 mm çaplı çok sayıda metastazla uyumlu noduller görülmüştür. MR incelemesinde trikuspit kapak seviyesinde sağ ventrikül lümenine doğru protrüzyon gösteren 45x35 mm ölçülerinde lobule kontürlü tümör izlenmiştir. Sol hemitoraksındaki kitle torakotomi ile çıkartılmıştır. Operasyon materyalilinin mikroskopik incelemesinde yer yer storiform paternde ve genellikle düzensiz yapılanma gösteren, hücre sınırları belirsiz iğsi hücrelerden oluşan selüler tümör görülmüştür. Arada miksoid değişiklik gösteren selülaritesi düşük alanlar izlenmiştir. Kardiak sinovyal sarkom bu bölgede çok nadir görülmesi ve tanı güçlüğü oluşturması nedeniyle olgumuz sunulmaya değer bulunmuştur.

Anahtar Kelimeler

Sinovyal sarkom, kalp, tümör

Kaynakça

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