Synovial Sarcoma in Head and Neck: A Case Report

Abstract

Introduction Synovial sarcoma is a malignant tumor of mesenchymal pluripotent cells. Objectives We present a case of synovial sarcoma in the posterolateral wall of the oropharynx. Resumed report The patient, a 23-year-old woman, was admitted with a history of dysphagia and difficulty in breathing for 8 months, resulting in progressive deterioration and onset of snoring, muffled voice, and local pain. An oropharyngeal tumor in the left posterolateral wall touched the base of the ipsilateral tongue. The patient underwent endoscopic pharyngectomy to remove the lesion. Pathologic examination revealed synovial sarcoma with positive margins, and Mohs technique was proposed for margin control. The margins were disease-free, without the need for total laryngectomy. The pharynx was reconstructed with a microvascular forearm flap. The patient developed postoperative stability. Conclusion Despite its name, synovial sarcoma is rarely sourced directly from synovial membranes. It is most commonly found in the vicinity of large joints. The location at the head and neck, a location poor in synovial tissue, is unusual. Synovial sarcoma in the head and neck has an aggressive nature and poor prognosis. Resection with negative margins remains the foundation of therapy, which is not so easily achieved in the head and neck. It is important for the otorhinolaryngologist and head and neck surgeon to be familiar with this aggressive tumor, which carries high mortality and morbidity. The appropriate diagnosis and treatment can improve prognosis and patient survival.

Synovialosarcoma of the pharynx: A case report and literatture review

“…Local excision is followed by high recurrence rates (60–90 %), usually within 2 years. Daveau et al study supports the use of adjuvant radiotherapy as it improved the overall survival rates with few recurrences in patients in whom the primary tumour was treated with surgical resection and radiotherapy [ 13 , 16 ]. Role of chemotherapy in the management of synovial sarcoma is still debatable.…”

“…There is no indication for prophylactic neck dissection except when palpable and enlarged lymph nodes arepresent [ 8 ]; Metastasis is mainly to the lungs, followed by lymph nodes and bone [ 13 ]. Most metastasis originate from haematogenous dissemination, although up to 20 % spread occur through the lymphatics to regional lymph node [ 16 ].…”

Primary Synovial Sarcoma of External Auditory Canal: A Case Report

“…Surgical resection is followed by up to 90% recurrence rate within two years [ 3 ]. The studies are controversial regarding pre and postoperative radiotherapy with or without chemotherapy even though this modality of treatment has been reported to improve the survival rates [ 6 ].…”

Primary synovial sarcoma of the thyroid gland: a CARE compliant case report and literature review

“…Synovial sarcoma is a kind of histological subtype of soft tissue sarcoma, making up 8–10% of all soft tissue sarcomas. It is a high-grade malignant neoplasm of mesenchymal pluripotent cells, characterized by a specific t(X;18) (p11.2; q11.2) translocation leading to the generation of SYT-SSX fusion gene transcripts ( 1 , 2 ). According to different ultra structures, synovial sarcoma was divided into monophasic patterns and classic biphasic patterns ( 2 ).…”