Monophasic Epithelial Synovial Sarcoma Accompanied by an Inverted Papilloma in the Sphenoid Sinus

Xiaohua Jiang,Jianguo Tang,Matthew R Hoffman,Qi Huang

doi:10.1155/2012/379720

Abstract

A 58-year-old man presented with a six-month history of intermittent blood-stained posterior nasal discharge. Five years ago, he had a three-week episode of fitful light headaches. Nasal ventilation, olfactory sensation, and facial sensation were normal; there were no ophthalmological complaints. Coronal computed tomography (CT) scans revealed soft masses in the bilateral sphenoid sinuses with bone absorption. The patient underwent bilateral functional endoscopic sinus surgery and resection of right nasal papillary masses. Papillary masses and mucosa in both sphenoid sinuses were also removed. The mass in the left sphenoid sinus was diagnosed as two separate entities, one being a primary monophasic epithelial synovial sarcoma and the other an inverted papilloma, while the mass in the right sphenoid sinus was an inverted papilloma. After surgery, the patient underwent radiotherapy and chemotherapy. At the 50-month follow-up visit, there were no signs of recurrence.

Highlights

Synovial sarcoma (SS) accounts for approximately 8% of all soft tissue sarcomas and is the fourth most common type of sarcoma
We report the first case of primary monophasic epithelial synovial sarcoma (MESS) in the sphenoid sinus; this sarcoma was part of a mass in one cell of the sphenoid sinus which was comprised of two separate parts, one being the synovial sarcoma and the other being an inverted papilloma
The septum dividing the right and left sphenoid sinuses was intact, and there was no communication between the right and left masses; we considered them to be separate entities

Summary

Introduction

Synovial sarcoma (SS) accounts for approximately 8% of all soft tissue sarcomas and is the fourth most common type of sarcoma. We report the first case of primary monophasic epithelial synovial sarcoma (MESS) in the sphenoid sinus; this sarcoma was part of a mass in one cell of the sphenoid sinus which was comprised of two separate parts, one being the synovial sarcoma and the other being an inverted papilloma.

Case Report

Findings

Discussion