Pulmonary sarcoid-like reaction in metastatic synovial sarcoma

A 22-year-old female patient, with synovial sarcoma of the left thigh, was treated with marginal resection and adjuvant chemoradiotherapy. Two years later, she developed sub-pleural metastatic nodules that were resected. Follow-up chest CT-scans revealed small yet new left lower lobe sub-pleural nodules, which were observed closely. These lesions progressed over time and, 20 months later, the patient underwent pulmonary metastasectomy. Histopathology examination of the lung tissue showed changes consistent with a sarcoid-like reaction. There were no systemic manifestations of sarcoidosis. To date, there have been no reported cases of sarcoid-like reaction associated with synovial sarcoma. Reporting this case, therefore, may help to improve our overall understanding of the relationship between malignancy and sarcoid-like reactions in the lungs.