Case Report Diagnostic dilemma of cardiac synovial sarcoma e Primary or secondary Kalpathi Krishnamani a , Linga Vijay Gandhi b, *, Narender Kumar Thota e , Gundeti Sadashivudu c , Digumarti Raghunadharao d , N. Rama Kumari f a Resident, Department of Medical Oncology, Nizam’s Institute of Medical Sciences, Punjagutta, Hyderabad 500082, India b Assistant Professor, Department of Medical Oncology, Nizam’s Institute of Medical Sciences, Punjagutta, Hyderabad 500082, India c Associate Professor, Department of Medical Oncology, Nizam’s Institute of Medical Sciences, Punjagutta, Hyderabad 500082, India d Professor, Department of Medical Oncology, Nizam’s Institute of Medical Sciences, Punjagutta, Hyderabad 500082, India e Assistant Professor, Department of Medical Oncology, Krishna Institute of Medical Sciences, Hyderabad, India f Associate Professor, Department of Cardiology, Nizam’s Institute of Medical Sciences, Punjagutta, Hyderabad 500082, India article info Article history: Received 12 March 2013 Accepted 6 May 2013 Available online 31 July 2013 Keywords: Cardiac Synovial sarcoma Primary Ifosfamide Pazopanib abstract Cardiac synovial sarcomas are rare tumors. Few cases are reported in literature. They commonly present with heart failure. Surgery is the primary modality of treatment where possible. Radiation and chemotherapy are used for local and systemic control as indicated. We present a rare case of synovial sarcoma with simultaneous cardiac and soft tissue involvement. The case is presented for its rarity and diagnostic difficulty in determining the primary site of origin. Copyright ª 2013, Indian College of Cardiology. All rights reserved. 1. Introduction Synovial sarcoma is a rare malignancy, comprising approximately 10% of all soft tissue sarcomas (STS). 1 It occurs most often in children and young adults and is an aggressive tumor with 10-year-overall survival rates as low as 0e20%. 2,3 A characteristic chromosomal abnor- mality t(X;18) is used for the confirmation of synovial sarcoma. 4 Primary or metastatic cardiac synovial sarcomas are very rare. We present a case of metastatic monophasic synovial sarcoma to heart. * Corresponding author. Tel.: þ91 9963167444 (mobile). E-mail address: vijaygandhilinga@yahoo.com (L.V. Gandhi). Available online at www.sciencedirect.com journal homepage: www.elsevier.com/locate/jicc journal of indian college of cardiology 3 (2013) 139 e142 1561-8811/$ e see front matter Copyright ª 2013, Indian College of Cardiology. All rights reserved. http://dx.doi.org/10.1016/j.jicc.2013.05.001