Synovial Sarcoma is a rare malignancy. It presents in adolescents and young adults. It occurs in soft tissue
of extremities usually near to the large joints, heart, lung, mediastinum, head and neck. A 23-year-old
female presented with a big hard fixed swelling in right supraclavicular region for 15 years. X-Ray chest
posterior-anterior view presented Homogenous opacity in upper lobe of right lung. USG of neck showed
large heterogeneous lobulated almost avascular solid mass in right side of root of neck and anterior upper
mediastinum may be associated with Schwannoma/ paraganglioma/soft tissue sarcoma. Spindle cell
lesion was reported by FNAC. MRI showed large slightly lobulated mass along right side of root of neck
and right side of superior mediastinum. A large soft tissue density mass along right side of neck and
superior mediastinum was found in CT scan. Surgical excision was done successfully. Histopathological
examination revealed spindle cell tumor favoring synovial sarcoma in the neck tissue and metastatic
spindle cell tumor in the lung lesion.