Synovial sarcoma of the cervical area

Synovial sarcoma of the head & neck: A review of reported cases in the literature

Synovial sarcoma is a high-grade malignancy that seldom manifests in the head and neck. The purpose of this paper is to provide a comprehensive review of the existing literature on primary HNSS. This review study includes case reports, case series and retrospective cohort studies on primary HNSS published in the English language. All cases identified via PubMed were analyzed individually. Articles were included according to specified eligibility criteria. The total number of cases analyzed was 243 (91 case reports, 53 cases from 16 case series, and 99 cases from 8 retrospective cohort studies). The average age at the time of HNSS diagnosis was 33.5 years. The ratio of male-to-female was 1.64:1. The most frequently occurring histologic subtype was biphasic (59.2%). The most common location was the neck. Hoarseness was the most common presenting symptom. Almost all patients (98.3%) underwent surgical excision. 55.6% of patients received adjuvant radiotherapy. A smaller number of patients (30.7%) received adjuvant chemotherapy. 60.3% of patients were alive with no evidence of disease at follow-up while 28.0% of patients died of HNSS at follow-up. The average follow-up period was 52.0 months. Synovial sarcoma is a rare head and neck malignancy. Surgical excision with adjuvant radiation is the most frequently employed treatment modality. Regardless of treatment modality, the prognosis of the tumor is guarded.

Retropharyngeal synovial sarcoma in an infant: report of a case and of its response to chemotherapy; review of the literature

Synovial sarcoma of the retropharynx is an extremely rare neoplasm. To date, only 10 cases have been reported in patients less than 15 years old. Our 15-month-old patient is, to our knowledge, the youngest ever reported with a retropharyngeal synovial sarcoma in the world literature. In the past, treatment usually consisted of surgery followed by radiotherapy or adjuvant chemotherapy, or both. In the case reported here, combination chemotherapy (ifosfamide, vincristine, and actinomycin D), used as the initial treatment modality, induced a dramatic decrease of the synovial sarcoma.

Synovial sarcoma of the esophagus

The occurrence of synovial sarcoma in sites other than the extremities is rare. Twelve cases in the hypopharynx but none in the esophagus have been described. A case of polypoid synovial sarcoma arising in the upper third of the esophagus in a 25-year-old man is reported. To the authors' knowledge, this is the first report of synovial sarcoma arising in the esophagus. The pathologic findings, ultrastructural studies, and results of surgical management and radiotherapy are discussed.

Orofacial synovial sarcoma: a clinicopathologic study of 11 new cases and review of the literature

Synovial sarcoma arises most commonly in the lower extremity, particularly in the region of the lower thigh and knee. Yet the occurrence of thus 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.

Synovial sarcoma of the soft palate in a child: a light and electron microscopic study

An extremely rare case of synovial sarcoma localized in the soft palate of a 9-year-old boy is reported, describing all details noted during light and electron microscopic observation. All features characteristic of this mesenchymal tumour were evident in the light microscopy. Electron microscopy also confirmed the diagnosis. The text includes full particulars of the therapy administered.

Synovial cell sarcoma

Synovial sarcoma of the head and neck is a rare lesion. Based on previous literature reports, these lesions carry a poor prognosis. Case reports of two patients diagnosed and treated recently for head and neck lesions of this type are presented. A review of pathologic sections at the Armed Forces Institute of Pathology (AFIP) suggests that this lesion is more colmon than believed previously.

Synovial sarcoma of the hypopharynx

Primary synovial sarcoma of the hypopharynx is an extremely rare neoplasm. Only 16 cases could be traced in the literature so far. An additional case, in a 29-year-old male patient, is presented. Progressive disturbance of deglutition and speech, chocking sensation, and mild respiratory distress were his original complaints. Our case differs from those previously reported in that a) the tumor was pedunculated, and the site of its attachment could be very well-defined, and b) unusual intratumoral destructive hemorrhage turned the case into an emergency. The pedicle was radically excised together with part of the grossly uninvolved underlying tissue, and the tumor was removed in toto. The histological findings are described. The patient is under observation. No recurrence has been noticed 11 months after surgery, and there are no signs of metastasis. The origin of the tumor and its treatment are discussed.