AIIMS Nagpur recently made a pivotal achievement in the field of cancer treatment by successfully treating a patient suffering from synovial cell sarcoma, a rare and aggressive soft-tissue cancer. The 26 year old MBBS student from Bhopal was subjected to right pneumonectomy by health professionals from AIIMS Nagpur.
Pneumonectomy, the surgical procedure to completely remove one of the lungs was performed by Dr. Neelesh Shrivastava (assistant professor, surgical oncology) with Dr. Hemant Bawankar (CTVS), Dr. Shubhada Khanapure (surgical oncology) and Dr. Gajanan Chavan (anesthesiology) as his team members.
Synovial cell sarcoma is a mesenchymal tumor that presents mainly in adolescents and adults younger than 30. It is a relatively rare tumor, with 800 to 1000 cases reported annually. [1] It is commonly related to the joints of arms and legs. However, in this case, it was the chest wall where the cancer cells developed. Hence, making this case an extremely rare diagnosis. Similar to other soft tissue sarcomas, diagnosis of synovial cell sarcoma can be obtained from a combination of history, physical examination, magnetic resonance imaging, biopsy and subsequent pathology, immunohistochemistry and molecular analysis.[1]
The whole operation procedure was carried out with exceptional surgical precision and care by skilled surgeons as the proximate location of the tumor to a vital organ like heart made this a complicated and challenging task. Furthermore, post-surgery care of the patient in Surgical Intensive Care Unit (SICU) faced a few complications due to sepsis. However, with efficient antibiotic administration, the patient's health condition was managed.
The factors that made this surgery a significant milestone in the healthcare field is that the right pneumonectomy is associated with a higher mortality rate even in the absence of induction therapy. This is primarily related to the increased risk of bronchopleural fistula on the right. The increased number of bronchopleural fistulas on the right may be attributable to more extensive resection (surgical procedure to remove tumor). [2]
References
1. Gazendam AM, Popovic S, Munir S, Parasu N, Wilson D, Ghert M. Synovial Sarcoma: A Clinical Review. Curr Oncol. 2021 May 19;28(3):1909-1920. doi: 10.3390/curroncol28030177. PMID: 34069748; PMCID: PMC8161765. (Accessed on 20th January 2025)
2. Darling GE, Abdurahman A, Yi QL, Johnston M, Waddell TK, Pierre A, Keshavjee S, Ginsberg R. Risk of a right pneumonectomy: role of bronchopleural fistula. Ann Thorac Surg. 2005 Feb;79(2):433-7. doi: 10.1016/j.athoracsur.2004.07.009. PMID: 15680809. (Accessed on 20th January 2025)
3. https://www.instagram.com/reel/CpC1qZaP8VU/?igsh=MmN3dTl4Z201aXd3 (Accessed on 20th January 2025)
(Input from various sources)
(Rehash/Jithin Paul/MSM)