Abstract
Synovial sarcoma is a rare malignant neoplasm of soft tissue that typically arising near large joints of the upper and lower extremities in young adult males. Only 3% of these neoplasms have been found to arise in the head and neck region. To our knowledge, there are limited reports in the literature of this neoplasm in the cervical spine.A case of biphasic synovial sarcoma of the cervical spine is reviewed. A 29 year-old male presented with pain on the left side of the cervical spine. Physical examination revealed a global loss of cervical motion and large, palpable mass in the left paravertebral area. The long-delayed Magnetic Resonance (MR) scan revealed a soft tissue mass measuring 8.3 centimeters (cm) × 5.7 cm that was surgically removed. A malignant biphasic synovial sarcoma was diagnosed on pathologic examination.The clinical and imaging findings of an atypically located synovial sarcoma are reviewed. This case report emphasizes the consequences of a limited differential diagnosis, prolonged treatment and the failure to perform timely diagnostic imaging in the presence of a paraspinal mass.
Highlights
Synovial sarcoma is a seldom encountered, aggressive malignant neoplasm of soft tissue that typically arises near large joints of the upper and lower extremities in young adults
The anatomical distribution of synovial sarcomas is well documented with 85% located in the extremities [2] and just 3% located in the head and neck region [3]
Synovial sarcoma is a malignant neoplasm of soft tissue that typically arises near large joints of the upper and lower extremities in the young adult male, the knee; they do not arise from synovial tissue [1,8,9] but from malignant degeneration of primitive mesenchymal cells [9]
Summary
Synovial sarcoma is a seldom encountered, aggressive malignant neoplasm of soft tissue that typically arises near large joints of the upper and lower extremities in young adults. On MR imaging, synovial sarcomas usually appear as a heterogeneous soft-tissue mass and may have a multilocular appearance. MR scan, T1 weighted, coronal view without contrast, reveals a kidney bean shaped cystic mass that extends from C3 to T1. Treatment The prevailing therapeutic approach to high-grade soft tissue sarcomas is wide surgical resection followed by radiation, chemotherapy or both [7]. The patient in this case report underwent subtotal resection due to the size of the tumor. Seven weeks of post-operative radiation therapy was received and this was followed by a course of chemotherapy This patient is six years post resection without recurrence of the tumor
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