Primary synovial sarcoma of the lung with intra-cardiac extension.

Synovial sarcomas are a distinct clinical entity occurring most often in the lower extremities. They account for 10-14% of all soft tissue sarcomas. Pulmonary synovial sarcomas are quite rare and account for less than 0.5% of all intra-thoracic neoplasms. We present the first reported case of primary pulmonary synovial sarcoma with intra cardiac extension in a 53-year-old male who presented with chronic cough. Imaging revealed a large right upper lobe mass extending through the superior pulmonary veins into the left atrium. The patient underwent a right total pneumonectomy with extraction of the left atrial mass and left atrial reconstruction. Pathology and immunohistochemistry was diagnostic of primary pulmonary synovial sarcoma positive for SYT-SSX1 gene fusion transcription.

MRI features of cellular angiomyofibroma with pathologic correlation.

Within the spectrum of extratesticular mesenchymal tumors in the scrotum and perineum lies cellular angiofibroma, also known as angiomyofibroblastoma-like tumor, a rare lesion originally described to almost exclusively occur in the vulva, perineum, and pelvis of women. We report a case of this tumor, with an adjacent scrotal lipoma, occurring in a 60-year-old male who presented to our department with a firm palpable scrotal mass. To our knowledge, the MRI findings of this entity have yet to be described in the radiological literature. We present the MRI features of cellular angiofibroma that are consistent with the pathological characteristics of this entity-a benign cellular and fibrous tumor with prominent vascularity.

Unusually large extraintestinal GIST presenting as an abdomino-pelvic tumor.

BACKGROUND: Gastrointestinal stromal tumor (GIST) is a rare visceral tumor that may mimic ovarian tumor. CASE: A 56-year-old woman presented with a large abdomino-pelvic mass and moderately elevated CA-125. A large tumor occupying the whole abdominal cavity and pelvis was noted on laparotomy. In addition, multiple tumor nodules were seen from the ligament of Treitz to the terminal ileum involving only the surface intestine. The ovaries appeared normal. The tumor demonstrated spindle and epithelioid components and was found to be morphologically and immunohistochemically consistent with GIST. CONCLUSION: Gynecologists need to be cognizant of extra-ovarian pathology in the atypical presentation of a pelvic mass. Correct diagnosis is essential for proper management since GISTs specifically respond to the c-kit selective tyrosine kinase inhibitor, Imatinib mesylate.