Recurrent primary synovial sarcoma of the chest wall

We present a case of recurrent primary synovial sarcoma of the chest wall in a 55-year-old man. Imaging at the time of recurrence revealed extensive involvement of the left pleural cavity by the tumor. The patient developed severe congestive heart failure with restrictive/constrictive physiology and subsequently died in the hospital 5 months after initial presentation. At autopsy, the tumor encased the entire left lung in a rind-like fashion and diffusely involved the pericardium. Recurrent synovial sarcoma was confirmed by histological examination. Synovial sarcoma should be considered in the differential diagnosis of chest masses, especially in young or middle-aged adults.