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Shein G, Potter AJ, Loo C, Smee R, Jacobson I, Anazodo A. Paediatric Laryngeal Synovial Sarcoma: Dilemmas and Decision-Making. Case Rep Otolaryngol 2024; 2024:7574240. [PMID: 38590515 PMCID: PMC11001469 DOI: 10.1155/2024/7574240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Revised: 06/30/2022] [Accepted: 01/31/2024] [Indexed: 04/10/2024] Open
Abstract
Primary laryngeal synovial sarcoma is a rare head and neck cancer. We describe a case of synovial sarcoma of the larynx in a previously well 9-year-old boy with a one-month history of a progressively enlarging neck lump. He was referred to our institution after incomplete surgical excision of the then undifferentiated neck mass. A partial laryngectomy including wide local excision of the residual mass was performed. An ipsilateral level I-III neck dissection was also performed concurrently. Clear re-excision margins were achieved. The neck nodes were all negative for metastatic disease. Adjuvant local radiotherapy treatment was administered to reduce the probability of local recurrence. Four years following treatment completion, the patient remains in remission with no signs of treatment-related morbidity. A review of the published literature on laryngeal synovial sarcoma was undertaken. This case represents the youngest patient to be diagnosed with the condition. Surgical excision represents the mainstay of treatment of laryngeal synovial sarcoma. At more common sites of disease, adjuvant radiotherapy has been associated with lower rates of recurrence. However, there is the potential for significant morbidity from irradiating the neck of a paediatric patient. This case report explores the challenges in treating young patients with aggressive head and neck cancers when faced with little available evidence to guide decision-making.
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Affiliation(s)
- Gregory Shein
- Department of Otolaryngology, Sydney Children's Hospital, Randwick, Sydney, NSW 2031, Australia
| | - Alison J. Potter
- Melanoma Institute Australia, Sydney, Australia
- Faculty of Medicine, University of Sydney, Sydney, Australia
- Tissue Pathology and Diagnostic Oncology, Royal Prince Alfred Hospital, Sydney, Australia
- Faculty of Medicine, University of New South Wales, Sydney, Australia
| | - Christine Loo
- Department of Anatomical Pathology, Prince of Wales Hospital, Randwick, Sydney, NSW 2031, Australia
| | - Robert Smee
- Department of Radiation Oncology, Sydney Children's Hospital, Randwick, Sydney, NSW 2031, Australia
- The UNSW Clinical Teaching School, Prince of Wales Hospital, Sydney, New South Wales, Australia
- Department of Radiation Oncology, Tamworth Base Hospital, Tamworth, New South Wales, Australia
| | - Ian Jacobson
- Department of Otolaryngology, Sydney Children's Hospital, Randwick, Sydney, NSW 2031, Australia
- Department of Otolaryngology, Prince of Wales Hospital, Randwick, Sydney, NSW 2031, Australia
| | - Antoinette Anazodo
- Kids Cancer Centre, Sydney Children's Hospital, Sydney, NSW 2031, Australia
- Nelune Cancer Centre, Prince of Wales Hospital, Sydney, NSW 2031, Australia
- School of Women's and Children's Health, University of New South Wales, Sydney, NSW 2031, Australia
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Thierry B, Lesnik M, Luscan R, Leboulanger N. Total laryngectomy in children: Madness or method? Eur Ann Otorhinolaryngol Head Neck Dis 2024:S1879-7296(23)00165-5. [PMID: 38233299 DOI: 10.1016/j.anorl.2023.11.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2024]
Affiliation(s)
- B Thierry
- Service d'ORL et de chirurgie cervico-faciale, hôpital universitaire Necker enfants malades, 149, rue de Sèvres, 75015 Paris, France
| | - M Lesnik
- Institut Curie, 75005 Paris, France
| | - R Luscan
- Service d'ORL et de chirurgie cervico-faciale, hôpital universitaire Necker enfants malades, 149, rue de Sèvres, 75015 Paris, France
| | - N Leboulanger
- Service d'ORL et de chirurgie cervico-faciale, hôpital universitaire Necker enfants malades, 149, rue de Sèvres, 75015 Paris, France; Université Paris Cité, Paris, France.
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Matthews CN, Salman S, Mustafa SF, Misra D. Cardiogenic and obstructive shock: primary laryngeal synovial sarcoma with cardiac metastasis. BMJ Case Rep 2023; 16:e257431. [PMID: 38042527 PMCID: PMC10693874 DOI: 10.1136/bcr-2023-257431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2023] Open
Abstract
A man in his 20s with a history of laryngeal synovial sarcoma presented with dyspnoea. Imaging revealed a large right ventricular (RV) mass, which was resected, and histological analysis indicated synovial sarcoma recurrence. Within 1 month of RV mass resection, the tumour progressed with paratracheal metastasis. The lumen was nearly obliterated, and right ventricular outflow tract (RVOT) obstruction led to rapid deterioration with mixed cardiogenic and obstructive shock. We present a rare case of primary laryngeal synovial sarcoma metastasising to the heart.
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Affiliation(s)
- Christopher N Matthews
- Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Sidra Salman
- Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Syed Farrukh Mustafa
- Mount Sinai Fuster Heart Hospital, Mount Sinai Health System, New York, New York, USA
| | - Deepika Misra
- Mount Sinai Fuster Heart Hospital, Mount Sinai Health System, New York, New York, USA
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Sharma AE, Kerr DA, Cipriani NA. Small biopsies in the head and neck: Bone and soft tissue. Semin Diagn Pathol 2023; 40:353-370. [PMID: 37453847 DOI: 10.1053/j.semdp.2023.06.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2023] [Revised: 04/30/2023] [Accepted: 06/21/2023] [Indexed: 07/18/2023]
Abstract
Bone and soft tissue lesions in the head and neck encompass not only a broad morphologic spectrum but also significant inherent clinicopathologic overlap. Epidemiology, radiology, and location - similar to the diagnostic assessment in other sites - are especially important considerations in the context of an established mesenchymal proliferation. Herein, the approach towards diagnosis is stratified by morphology (spindle, sarcomatoid, epithelioid, round cell), cellular lineage (fibroblastic, nerve sheath, rhabdomyogenic), and tumor grade (benign, low- to high-grade malignant) as the basis of further immunohistochemical or molecular investigation.
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Affiliation(s)
- Aarti E Sharma
- Hospital for Special Surgery, New York, NY, United States
| | - Darcy A Kerr
- Dartmouth Hitchcock Medical Center, Lebanon, NH, United States
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Chiesa-Estomba CM, Barillari MR, Mayo-Yáñez M, Maniaci A, Fakhry N, Cammaroto G, Ayad T, Lechien JR. Non-Squamous Cell Carcinoma of the Larynx: A State-of-the-Art Review. J Pers Med 2023; 13:1084. [PMID: 37511697 PMCID: PMC10381862 DOI: 10.3390/jpm13071084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Revised: 06/21/2023] [Accepted: 06/28/2023] [Indexed: 07/30/2023] Open
Abstract
(1) Background: Non-squamous cell laryngeal carcinoma includes endothelial tumors, such as minor salivary gland tumors, lymphoepithelial tumors, neuroendocrine tumors, soft and hard tissue sarcomas, and malignant melanomas. (2) Methods: A state-of-the-art review using the MEDLINE/PUBMED, Google Scholar, Ovid Medline, Embase, and Scopus electronic databases was performed. (3) Conclusions: In order to optimize overall treatment outcomes, a multidisciplinary, patient-centered approach to the management of non-SCC of the larynx must be adopted universally; a national or international registry on non-SCC laryngeal cancer can be useful to improve understanding about the behavior of this kind of tumor.
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Affiliation(s)
- Carlos M Chiesa-Estomba
- Department of Otorhinolaryngology, Donostia University Hospital, Osakidetza, 20014 San Sebastian, Spain
- Head & Neck Study Group, Young-Otolaryngologists of the International Federations of Oto-Rhino-Laryngological Societies (YO-IFOS), 13005 Marseille, France
| | - Maria Rosaria Barillari
- Head & Neck Study Group, Young-Otolaryngologists of the International Federations of Oto-Rhino-Laryngological Societies (YO-IFOS), 13005 Marseille, France
- Division of Phoniatrics and Audiology, Department of Mental and Physical Health and Preventive Medicine, University of L. Vanvitelli, 81100 Naples, Italy
| | - Miguel Mayo-Yáñez
- Head & Neck Study Group, Young-Otolaryngologists of the International Federations of Oto-Rhino-Laryngological Societies (YO-IFOS), 13005 Marseille, France
- Otorhinolaryngology-Head and Neck Surgery Department, Complexo Hospitalario Universitario A Coruña (CHUAC), 15006 A Coruña, Spain
| | - Antonino Maniaci
- Head & Neck Study Group, Young-Otolaryngologists of the International Federations of Oto-Rhino-Laryngological Societies (YO-IFOS), 13005 Marseille, France
- Department of Medical and Surgical Sciences and Advanced Technologies "GF Ingrassia", ENT Section, University of Catania, Via S. Sofia 78, 95125 Catania, Italy
| | - Nicolas Fakhry
- Head & Neck Study Group, Young-Otolaryngologists of the International Federations of Oto-Rhino-Laryngological Societies (YO-IFOS), 13005 Marseille, France
- Department of Otorhinolaryngology-Head and Neck Surgery, APHM, La Conception University Hospital, 13005 Marseille, France
| | - Giovanni Cammaroto
- Head & Neck Study Group, Young-Otolaryngologists of the International Federations of Oto-Rhino-Laryngological Societies (YO-IFOS), 13005 Marseille, France
- Department of Otolaryngology-Head & Neck Surgery, Morgagni Pierantoni Hospital, 47100 Forli, Italy
| | - Tareck Ayad
- Head & Neck Study Group, Young-Otolaryngologists of the International Federations of Oto-Rhino-Laryngological Societies (YO-IFOS), 13005 Marseille, France
- Division of Otolaryngology-Head & Neck Surgery, Centre Hospitalier de L'Université de Montréal, Montreal, QC H2X 0C1, Canada
| | - Jerome R Lechien
- Head & Neck Study Group, Young-Otolaryngologists of the International Federations of Oto-Rhino-Laryngological Societies (YO-IFOS), 13005 Marseille, France
- Department of Otolaryngology-Head & Neck Surgery, Foch Hospital, School of Medicine, UFR Simone Veil, Université Versailles Saint-Quentin-en-Yvelines (Paris Saclay University), 91190 Paris, France
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MacNeil SD. Non-squamous Laryngeal Cancer. Otolaryngol Clin North Am 2023; 56:345-359. [PMID: 37030947 DOI: 10.1016/j.otc.2023.01.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/09/2023]
Abstract
The pathology of non-squamous carcinoma of the larynx is broad and there is a wide differential diagnosis. The most common presenting symptoms for laryngeal malignancies, both squamous and non-squamous, are hoarseness and dyspnea. Presentation with persistent or worsening symptoms and a submucosal lesion should raise suspicion for a non-squamous malignancy of the larynx. Accurate histology determines the most appropriate treatment and has an impact on prognosis.
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Quan H, Sreekissoon S, Wang Y. Synovial sarcoma of the head and neck: A review of reported cases on the clinical characteristics and treatment methods. Front Cell Dev Biol 2022; 10:1077756. [PMID: 36684451 PMCID: PMC9853006 DOI: 10.3389/fcell.2022.1077756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2022] [Accepted: 12/12/2022] [Indexed: 01/08/2023] Open
Abstract
Synovial sarcoma (SS) is a high-grade soft-tissue sarcoma that occurs predominantly in older children and young adults in their thirties. It is usually very challenging to diagnose and treat synovial sarcoma in the head and neck region. The purpose of this review is to investigate the clinical manifestations and different treatment methods in the management of primary synovial sarcoma of the head and neck. HNSS has an aggressive nature and poor prognosis. Surgical resection, radiotherapy, and chemotherapy are the primary treatment methods. Typically, surgical resection with negative margins remains the foundation of therapy, which is not very easily achieved in the head and neck due to its complex anatomical structure and the presence of many blood vessels and nerves. However, synovial sarcoma has a high recurrence rate, so aggressive management and close follow-up are warranted for the optimal outcome.
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Affiliation(s)
- Hongzhi Quan
- Department of Oral Maxillofacial Surgery, Xiangya Stomatological Hospital and School of Stomatology, Central South University, Changsha, Hunan, China
| | - Senjeet Sreekissoon
- Department of Oral Maxillofacial Surgery, Xiangya Stomatological Hospital and School of Stomatology, Central South University, Changsha, Hunan, China
| | - Yan Wang
- School and Hospital of Stomatology, Wenzhou Medical University, Wenzhou, Zhejiang, China
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Mur TA, Pellegrini WR, Jaleel Z, Edwards HA, Levi JR. Pediatric laryngeal sarcoma: Systematic review and pooled analysis. Int J Pediatr Otorhinolaryngol 2020; 139:110471. [PMID: 33120103 DOI: 10.1016/j.ijporl.2020.110471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Revised: 10/19/2020] [Accepted: 10/20/2020] [Indexed: 12/24/2022]
Abstract
BACKGROUND Sarcomas are a rare, diverse tumor class of mesenchymal origin affecting all age groups. Survival after diagnosis is influenced by disease site. To date, there are no analyses evaluating treatment of pediatric sarcoma within the larynx specifically. METHODS A structured literature review following PRISMA guidelines was preformed to identify case reports of pediatric (age 17 and younger) laryngeal sarcoma. RESULTS Twenty-nine case reports documenting 37 pediatric patients diagnosed with sarcoma in the larynx were identified since 1980. The majority of patients were male (79.4%). The most common histological subtypes were rhabdomyosarcoma (69.4%) and synovial sarcoma (19.4%). The supraglottis was the most common site of disease (62.1%) among laryngeal subsites. Only two patients were known to have succumbed to their disease. Overall survival was not statistically impacted by primary site of tumor, treatment strategy, histology or gender. CONCLUSIONS Soft tissue sarcoma is rarely found in the pediatric larynx. Patient and tumor characteristics studied were not shown to affect outcomes. Increased documenting of high-quality case reports is needed to advance understanding of this disease.
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Affiliation(s)
- Taha A Mur
- Department of Otolaryngology-Head and Neck Surgery, Boston University Medical Center, Boston, MA, USA
| | | | - Zaroug Jaleel
- Boston University School of Medicine, Boston, MA, USA
| | - Heather A Edwards
- Department of Otolaryngology-Head and Neck Surgery, Boston University Medical Center, Boston, MA, USA; Boston University School of Medicine, Boston, MA, USA
| | - Jessica R Levi
- Department of Otolaryngology-Head and Neck Surgery, Boston University Medical Center, Boston, MA, USA; Boston University School of Medicine, Boston, MA, USA.
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