Pericardial synovial sarcoma in a dyspnoeic female with tuberculous pericarditis: A case report

Synovial sarcomas of the pericardium are extremely rare and associated with poor survival rate. The current case report describes a 45-year-old female who presented with dyspnea upon exertion, a paroxysmal cough, night sweats and recurrent pericardial effusion. The patient was diagnosed with tuberculous pericarditis and received antituberculous drug therapy. Echocardiography and magnetic resonance imaging (MRI) revealed a pericardial mass lying predominantly over the right atrium. The patient was treated by surgical excision and a subsequent histological analysis confirmed the diagnosis of a pericardial synovial sarcoma. Under high power examination, a characteristic biphasic appearance consisting of hypercellular spindled cell sheets was observed. Immunohistochemistry demonstrated positive staining for epithelial membrane antigen (EMA), vimentin and Bcl 2. The patient was then referred for adjuvant chemotherapy with a combination of adriamycin and ifosfamide. The patient has since remained clinically free of disease for 32 months.