Synovial sarcoma masquerading as thyroglossal cyst carcinoma

Abstract

<p class="abstract">Synovial cell sarcoma is very rare in head and neck. It is usually seen in the extremities in close relation to the bursae and joints. In head and neck, most of the cases reported are in the retrohyoid, parapharyngeal and retropharyngeal areas. Reporting the case of a 18 year old man who presented with signs and symptoms of thyroglossal cyst. Radiological findings were suggestive of a haemorrhagic thyroglossal cyst or a cystic neoplasm. Frozen section revealed a malignant spindle cell neoplasm of mesenchymal origin. A Sistrunk operation was done. Histopathological and immunohistochemical analysis yielded a diagnosis of monophasic synovial sarcoma. Patient underwent intensity modulated radiotherapy according to tumor board decision. Follow up PET Scans were negative. We are reporting this case to highlight the rarity of the condition and the high index of suspicion required to diagnose such a synovial sarcoma in this area. Treatment should be aimed at complete surgical resection of the tumor and appropriate adjuvant radiotherapy.</p>