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Objective: We present a case of intra-articular synovial sarcoma of the knee with expansion to the distal thigh with developed metastatic lung disease. The case was complicated by the detection of primary pulmonary adenocarcinoma.
Case: A 70 year age woman reported pain in the right knee during a routine check–up. Ultrasound (US) finding was inconclusive since the detected intra–articular tumor, appeared to be a partially organised haematoma. Magnetic resonance imaging (MRI) indicated the tumor corresponds to SS, and radical tumor resection was performed. Due to developed distant lung metastases, the patient received two different chemotherapy protocols. Good response to the second chemotherapy enabled video–assisted thoracoscopic surgery and removal of the remaining deposits in the left lung. Unexpected detection of primary adenocarcinoma of the lung and its metastases required a new chemotherapy protocol, which the patient is currently undergoing.
Conclusion: SS's insidious onset and infrequency often delay the diagnosis. Common occurrences of lung metastases require the selection of adequate chemotherapy, and continuous follow – up. Laboratory and radiographic monitoring remain mandatory to ensure the absence of both primary diseases and to detect recurrent metastatic activity.
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