Synovial sarcoma occurring in the anterior abdominal wall

Sarcomas were produced in and around the knee joint of rats by the injection of DMBA into the joint cavity. A study of the early changes that occur in the synovium and the continuity of the established tumor with this tissue strongly suggests that the experimental procedure employed produced tumors from the synovium and the superficial layers of the subsynovial tissues. Convincing histological evidence of synovial differentiation was seen only in six cases. Eleven other tumors were considered to be either fibrosarcomas or anaplastic sarcomas of synovial origin.

Experimentally produced synovial sarcomas

Ghadially

Roy

1966

Synovial sarcoma of the neck: A followup study of 24 cases

Roth

Enzinger

Tannenbaum

1975

189

108

This article reviews the clinicopathologic features and the biological behavior of 24 cases of synovial sarcoma that took origin from the cervical prevertebral connective tissue space and manifested as a retropharyngeal tumor or as a palpable mass in the anterior or posterior cervical triangle. The age of the 24 patients ranged from 10 to 51 years, with a median of 19 years. Ten patients were women and 14 men. Hoarseness or difficulty in breathing or swallowing were the first symptoms in eight patients. The tumors were solitary and ranged from 2 to 10 cm in greatest dimension. Microscopically, all of the cases showed the characteristic biphasic cellular pattern of a synovial sarcoma, with epi-thelioid and fibrosarcoma-like areas in varying proportions. Synovioblastic origin of the neoplasm was confirmed by the results of histochemical staining procedures and, in 1 case, by the examination with the electron microscope. Of the 21 cases with followup information, 12 had died (10 with pulmonary metas-tasis) and 9 were alive and free of symptoms. Prompt and complete surgical removal is required to prevent complications from recurrent tumor growth or metastasis.

Orofacial synovial sarcoma. A clinicopathologic study of 11 new cases and review of the literature

Shmookler¹,

Enzinger²,

Brannon³

1982

123

Synovial sarcoma arises most commonly in the lower extremity, particularly in the region of the lower thigh and knee. Yet the occurrence of this mesenchymal neoplasm in the head and neck area has been convincingly documented, albeit confined almost exclusively to cervical and parapharyngeal sites. Therefore, in view of its rarity in the head and neck, we analyzed a group of 11 synovial sarcomas arising in the orofacial region. The series comprised nine men (82%) and two women (18%). In common with synovial sarcoma at more conventional sites, this is a disease of young adults: ages ranged from 16–49 years (median, 34 years). Topographically, two subsets were delineated, a more common facial group with eight cases (four cheek, two parotid region, one infraorbital, one submental), all arising as gradually enlarging, usually nontender, solitary tumors; and three intraoral ones (two tonsillar, one lingual), two of which were polypoid and one was an exophytic tonsillar mass which presented with hemoptysis and stridor. Follow‐up data, obtained for nine patients (range, 1.3–15.0 years), disclosed three (33%) tumor related deaths, all belonging to the facial group. Treatment, difficult to significantly correlate with survival in this small series, varied from surgical excision alone to a multimodality approach including both irradiation and chemotherapy. Histologically, all the neoplasms revealed characteristic biphasic features, predominantly fibrosarcomatous in one, but, more typically, showing epithelial clefts and/or pseudoacinar spaces in the others. Differential diagnosis, depending on the proportion of the biphasic components, ranged from spindle cell mesenchymal neoplasms to various adenocarcinomas, including those arising in mixed tumors of salivary gland.