CONCLUSION
Primary pericardial synovial sarcomas are exceedingly uncommon. Complete
surgical resection is critical to prolong long-term survival. Technical
surgical guidance for complex tumors is lacking. This report describes
the successful resection of an extensive and invasive pericardial
synovial sarcoma using a modified autotransplantation technique with
adjuvant radiation for microscopic positive margins. Surgical technical
aspects are described. Our case can be of benefit to cardiac surgeons
embracing challenging cases. Overall, careful patient selection, a
thorough surgical plan and understanding of anatomy and physiology,
expertise in transplantation, and availability of skilled, senior
cardiothoracic surgeons at a center of excellence are critical for
success. The modification of resection as required may help improve
outcomes.