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E.G. 54 year - old female Housewife. History. 1994: C alcifi ed leiomyoma at the r ight foot Excision 1997: Recurrence in the same place Excision
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E.G. 54 year-old female Housewife
History • 1994: Calcified leiomyoma at the right foot Excision • 1997: Recurrence in the same place Excision • 2001: Recurrence in same the place Synovial sarcoma . Excision • 2003: Three metastases in the left lung Resection • 2004: A new metastasis in the left lung Resection . 6 cycles of ifosfomide+doxorubicine • 2005: New metastases in lungs 15 cycles of . methotrexate
Symptoms28.4.2006 • Dyspnea • Cough • Wheezing
Suggestion? • Bronchoscopy • Radiotherapy • Resection of metastases
Bronchoscopy • Radiotherapy • Resection of metastases
Suggestion? • Open surgery • Stent • LASER • APC • Cryotherapy • Electro-surgical snare
Open surgery • Stent • LASER • APC • Cryotherapy • Electro-surgical snare
Control after 2 weeks 12.5.06
After 25 days Wheezing and hemoptysis 07.6.06
Suggestion? • Brachytherapy • External radiotherapy • Surgery
Brachytherapy • External radiotherapy • Surgery
20.6.06 750 cGy 27.6.06 750 cGy 05.7.06 750 cGy Brachytherapy
Cyanosis, hypotension Referral to the emergency unit28.2.07 Pulmonary embolus Excitus
Conclusion • Metastatic synovial sarcoma growing rapidly from a single focus without invading the surrounding structures • Positive impact to survival and quality of life with local therapies