Lung metastases from synovial sarcoma simulating granulomas

Synovial sarcoma is a rare tumor of soft tissues, occurring chiefly in the extremities and limb girdles with a propensity for local recurrence and metastases to the lungs. The prognosis is generally poor, but long standing remissions after radical surgery have been reported. Calcification in the primary tumor is seen in about 30% of patients. To our knowledge, however, calcified pulmonary metastases in synovial sarcoma have not been reported. An unusual case of a synovial sarcoma of the thigh with calcified pulmonary metastases is reported. Three calcified pulmonary nodules were found 9 years after resection of the patient's primary synovial sarcoma. Each nodule showed a different pattern of calcification and mimicked a benign process; one nodule resembled a hamartoma and the other two nodules resembled granulomas.