Primary synovial sarcoma is a soft tissue tumor which originates from synoviallikeundeveloped mesenchymal structures. Here, we report the case of a giantmediastinal sarcoma in a 41-year-old female patient. After diagnosis, she underwentneoadjuvant chemotherapy. Due to its low efficacy, we collegially decidedto undergo cytoreductive debulking surgery. The mass invaded the phrenic nervebilaterally and its excision caused a severe lesion of the left nerve and a partialimpairment of the right one. Thus, plastic surgeons decided to reconstruct theright phrenic nerve employing the contralateral remaining fibers.The invasiveness of this tumor, its difficult removal, histological profile and thepeculiar technique to preserve diaphragmatic function classify this case as veryrare. The therapeutic strategy was based on interdisciplinary teamwork whichcomprised several specialists’ opinions. Our strategy allowed us to pursue thechallenging objective to give a young woman with a severe diagnosis the bestpossible chance of achieving a good quality of life.To the best of our knowledge, this phrenic nerve reconstructive technique is veryrare and has not previously been reported in the literature. The report emphasizesthat it is possible to deal with an apparently impossible case through a collaborativeapproach involving several different medical specialist professionals.

Importance of muldisciplinary management of giant mediastinal sarcoma with phrenic nerve recontruction: a case report

Stilo F;Zito A;Crucitti P
2020-01-01

Abstract

Primary synovial sarcoma is a soft tissue tumor which originates from synoviallikeundeveloped mesenchymal structures. Here, we report the case of a giantmediastinal sarcoma in a 41-year-old female patient. After diagnosis, she underwentneoadjuvant chemotherapy. Due to its low efficacy, we collegially decidedto undergo cytoreductive debulking surgery. The mass invaded the phrenic nervebilaterally and its excision caused a severe lesion of the left nerve and a partialimpairment of the right one. Thus, plastic surgeons decided to reconstruct theright phrenic nerve employing the contralateral remaining fibers.The invasiveness of this tumor, its difficult removal, histological profile and thepeculiar technique to preserve diaphragmatic function classify this case as veryrare. The therapeutic strategy was based on interdisciplinary teamwork whichcomprised several specialists’ opinions. Our strategy allowed us to pursue thechallenging objective to give a young woman with a severe diagnosis the bestpossible chance of achieving a good quality of life.To the best of our knowledge, this phrenic nerve reconstructive technique is veryrare and has not previously been reported in the literature. The report emphasizesthat it is possible to deal with an apparently impossible case through a collaborativeapproach involving several different medical specialist professionals.
Diaphragm paralysis, ; mediastinal mass,; sarcoma
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/20.500.12610/8177
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