Synovial Sarcoma of the Head and Neck

Abstract

Objective: To investigate the relationship between pathological diagnosis and clinical outcome of synovial sarcoma (SS) of head and neck. Method: Thirty-nine cases of SS in head and neck region from 1966 to 2011 were retrospectively studied by reviewing the pathological slices of the operative specimen and followed-up from 1 to 16 years with a mean time of 4 years postoperatively. Results: All patients were men aged from 8 to 66 years old with a mean age of 35 years and the disease demonstrated a predilection for lateral upper neck. Pathologically, 18 cases were biphasic, 17 cases were monophasic, and 3 cases were low-differentiated SS. Four cases were proved by cytogenetic methods of either fluorescence in situ hybridization (FISH) or/and RT-PCR. Six cases experienced repeated recurrence with the most up to 4 times operations after sole surgical approach. No lymphatic metastasis was observed during the 1- to 16-year follow-up. One patient developed scalp, arms, thoracic, and abdominal wall metastases during the postoperative 6-year follow-up, and one patient developed likely pulmonary metastatic foci but showed no growth and was not pathologically confirmed during the postoperative 2-years’ follow-up. Sixteen patients received adjuvant radiotherapy or chemotherapy. Nine patients died, but no death was directly associated with SS. Conclusion: The locoregional control of SS seemed related more closely to the anatomy of the tumor location rather than pathological patterns. SS of head and neck is a special entity that has good prognosis, cytogenetic methods are recommended to be employed to ascertain the diagnosis in order to choose reasonable treatment protocols.