From fine‐needle aspiration cytology to fluorescent in‐situ hybridization in an unusual case of pharyngeal synovial sarcoma

Abstract

Synovial sarcoma arising in the pharynx is a rare entity, with very few cases described in literature, mainly as surgical‐oriented case reports. We report the case of a healthy 20‐year old man who presented with a painless right neck mass, clinically suspicious for a thyroid nodule. Ultrasound scan and fine‐needle aspiration cytology failed to provide a definitive result, although suggesting a mesenchymal proliferation, in accordance with magnetic resonance imaging findings. Therefore, the lesion was removed with a minimally invasive surgical intervention. Definitive histologic and immunohistochemical examination of the surgical specimen revealed a biphasic synovial sarcoma, further validated by the detection of SS18 gene rearrangement on fluorescent in‐situ hybridization examination. Although rarely, synovial sarcoma may arise in the pharynx. Radiological, cytological, histological and molecular findings are needed along each step of the diagnostic process.