{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,22]],"date-time":"2025-12-22T00:05:18Z","timestamp":1766361918529,"version":"3.40.5"},"reference-count":8,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"51","license":[{"start":{"date-parts":[[2023,12,22]],"date-time":"2023-12-22T00:00:00Z","timestamp":1703203200000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2023,12,22]]},"abstract":"\n Rationale:<\/jats:title>\n Primary pulmonary synovial sarcoma is a rare malignant pulmonary tumor accompanied by calcifications in approximately 15% of cases. These calcifications usually have a fine, stippled appearance; coarse shapes have seldom been reported. Moreover, the presence of coarse calcifications often suggests benign tumors, which vastly differ in treatment. We present a rare case of primary pulmonary sarcoma with coarse intratumoral calcifications, the diagnosis of which was delayed because of its radiologic appearance.<\/jats:p>\n <\/jats:sec>\n \n Patient concerns:<\/jats:title>\n A computed tomography (CT) scan of a 69-year-old man with right upper quadrant (RUQ) pain revealed an incidental mass at the base of the right lower lobe, the margin of which was not well described with respect to the liver, and intratumoral coarse calcification was noted. Initially, the lesion was believed to be hepatic, and magnetic resonance imaging (MRI) was performed. Based on its imaging features, the mass was thought to be a pulmonary lesion, and a preliminary diagnosis of a benign lesion, such as a hamartoma or granuloma, was made. Four months after the initial CT scan, the patient\u2019s RUQ pain had aggravated; however, no change in the mass was observed on follow-up CT.<\/jats:p>\n <\/jats:sec>\n \n Diagnosis:<\/jats:title>\n The final diagnosis was primary pulmonary sarcoma, proven by surgical biopsy.<\/jats:p>\n <\/jats:sec>\n \n Interventions:<\/jats:title>\n Wedge resection of the right lower lobe was performed, and the patient received adjuvant chemotherapy.<\/jats:p>\n <\/jats:sec>\n \n Outcomes:<\/jats:title>\n The patient\u2019s RUQ pain improved, and no recurrence or metastasis has been reported to date.<\/jats:p>\n <\/jats:sec>\n \n Lessons:<\/jats:title>\n This case describes a rare presentation of a primary pulmonary synovial sarcoma with coarse intratumoral calcifications and the MRI features of the lesion. Intratumoral coarse calcifications often suggest benign lesions, such as hamartomas or post-inflammatory granulomas; however, as malignant lesions cannot be completely excluded, other radiologic and clinical features should be considered carefully. Focal areas of enhancement and eccentric calcification distribution might suggest malignant lesions such as primary pulmonary synovial sarcoma. Furthermore, despite not being used routinely, MRI scans might be helpful because advanced MRI techniques, such as diffusion-weighted imaging, can help distinguish malignant lesions from benign lesions. If the clinical course of a patient suggests malignancy, a more aggressive biopsy strategy should be considered.<\/jats:p>\n <\/jats:sec>","DOI":"10.1097\/md.0000000000036620","type":"journal-article","created":{"date-parts":[[2023,12,22]],"date-time":"2023-12-22T19:02:07Z","timestamp":1703271727000},"page":"e36620","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":2,"title":["Primary pulmonary synovial sarcoma with delayed diagnosis in a 69-year-old man: A case report"],"prefix":"10.1097","volume":"102","author":[{"given":"Chan Seop","family":"Kim","sequence":"first","affiliation":[{"name":"Department of Radiology, Chungbuk National University Hospital, Cheongju, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hye Soo","family":"Cho","sequence":"additional","affiliation":[{"name":"Department of Radiology, Seoul National University Hospital, Seoul, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ok Jun","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Pathology, Chungbuk National University College of Medicine, Cheongju, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Su Yeon","family":"Ahn","sequence":"additional","affiliation":[{"name":"Department of Radiology, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0007-1960","authenticated-orcid":false,"given":"Jin Young","family":"Yoo","sequence":"additional","affiliation":[{"name":"Department of Radiology, Chungbuk National University College of Medicine and Hospital, Cheongju, Korea."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","reference":[{"key":"R1-20250503","doi-asserted-by":"crossref","first-page":"1909","DOI":"10.3390\/curroncol28030177","article-title":"Synovial sarcoma: a clinical review.","volume":"28","author":"Gazendam","year":"2021","journal-title":"Curr Oncol"},{"key":"R2-20250503","doi-asserted-by":"crossref","first-page":"W730","DOI":"10.2214\/AJR.11.7342","article-title":"Characterization of synovial sarcoma calcification.","volume":"199","author":"Wilkerson","year":"2012","journal-title":"AJR Am J Roentgenol"},{"key":"R3-20250503","doi-asserted-by":"crossref","first-page":"339","DOI":"10.1097\/01.pas.0000147401.95391.9a","article-title":"Primary intrathoracic synovial sarcoma.","volume":"29","author":"B\u00e9gueret","year":"2005","journal-title":"Am J Surg Pathol"},{"key":"R4-20250503","doi-asserted-by":"crossref","first-page":"84","DOI":"10.1186\/1477-7819-8-84","article-title":"Highly malignant soft tissue sarcoma of the extremity with a delayed diagnosis.","volume":"8","author":"Park","year":"2010","journal-title":"World J Surg Oncol"},{"key":"R5-20250503","doi-asserted-by":"crossref","first-page":"e1392","DOI":"10.1097\/MD.0000000000001392","article-title":"Primary pulmonary synovial sarcoma in a tertiary referral center.","volume":"94","author":"Kim","year":"2015","journal-title":"Medicine (Baltimore)"},{"key":"R6-20250503","doi-asserted-by":"crossref","first-page":"W208","DOI":"10.2214\/AJR.11.8039","article-title":"Synovial sarcoma: imaging features of common and uncommon primary sites, metastatic patterns, and treatment response.","volume":"199","author":"Bakri","year":"2012","journal-title":"AJR Am J Roentgenol"},{"key":"R7-20250503","doi-asserted-by":"crossref","first-page":"67","DOI":"10.4103\/1817-1737.62469","article-title":"The calcified lung nodule: what does it mean?","volume":"5","author":"Khan","year":"2010","journal-title":"Ann Thorac Med"},{"key":"R8-20250503","doi-asserted-by":"crossref","first-page":"2589","DOI":"10.1007\/s00330-018-5817-0","article-title":"Soft tissue sarcoma: adding diffusion-weighted imaging improves MR imaging evaluation of tumor margin infiltration.","volume":"29","author":"Hong","year":"2019","journal-title":"Eur Radiol"}],"container-title":["Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.lww.com\/10.1097\/MD.0000000000036620","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,5,4]],"date-time":"2025-05-04T00:10:29Z","timestamp":1746317429000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.lww.com\/10.1097\/MD.0000000000036620"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,12,22]]},"references-count":8,"journal-issue":{"issue":"51","published-print":{"date-parts":[[2023]]}},"URL":"https:\/\/doi.org\/10.1097\/md.0000000000036620","relation":{},"ISSN":["0025-7974","1536-5964"],"issn-type":[{"type":"print","value":"0025-7974"},{"type":"electronic","value":"1536-5964"}],"subject":[],"published":{"date-parts":[[2023,12,22]]}}}