Synovial sarcoma of the head and neck: A review of reported cases on the clinical characteristics and treatment methods

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.

Keywords: clinical manifestations; diagnosis; management; synovial sarcoma of the head and neck; treatments.

FIGURE 1

Hematoxylin and eosin staining of the three histologic variants of synovial sarcoma (SS). (A,B) Slides of monophasic SS, made of spindle cells with moderate cytologic atypia and differentiated areas of variable cellularity. (C,D) Slides of biphasic SS composed by glandular-like structures with spindle cells without nuclear atypia. (E,F) Slides of poorly differentiated SS in its Ewing-like variant, with the presence of rosette-like structures (magnification: ×20).