A rare case of synovial sarcoma with lung heart and adrenal glandmetastasis: a caution for patients and clinicians

摘要

A 68-year-old man presented to the Urology Clinic, West China Hospital, Chengdu, with asuspected right adrenal gland mass that had persisted for two months. He had no associatedlumbodynia, dizziness or palpitation. Abdominal computed tomography (CT) revealed anuneven density and contrast-enhanced oval-like mass with smooth edges in the right adrenalgland. Laparoscopic right adrenal gland resection followed by histopathology confirmed adiagnosis of metastatic synovial sarcoma. The patient had a history of synovial sarcoma onthe right upper leg 3 years previously that was surgically treated, but he had notundergone further treatment. Approximately 1.5 years later, he had undergone surgery forheart and lung metastasis from the synovial sarcoma of the thigh. At 5 months followinglaparoscopic right adrenal gland resection, abdominal CT showed a significant sign ofright adrenal recurrence, and targeted therapy of 12 mg oral anlotinib, daily, wasinitiated. This relatively rare but alarming case highlights the importance of patientunderstanding and compliance to treatment.