Monophasic synovial sarcoma of the hypopharynx excised by transoral laser microsurgery

Abstract

An overwhelming majority of primary tumors of the hypopharynx are squamous cell carcinomas, accounting for approximately 95%. Synovial sarcoma (SS) is exceedingly rare at this anatomical site. A 41-year-old, otherwise healthy male presented with a 2-year history of dyspnea and dysphonia. Flexible laryngoscopy revealed a very large, well-circumscribed, pedunculated mass with near-total airway obstruction. On computed tomography imaging, a 4.7 cm × 2.6 cm supraglottic mass was demonstrated. Transoral CO2 laser microsurgery was carried out for en bloc removal. Final margins were clear and the patient is currently disease-free and symptom-free. Since the first case of head and neck SS was described in 1954, there have been fewer than 200 cases reported in the world literature. To the best of our knowledge, this is the first known case of a laryngeal SS that presented with airway obstruction which was managed with a negative-margin transoral CO2 laser microsurgery resection.