Primary biphasic synovial sarcoma of left parapharyngeal region: an exceedingly rare site
Keywords:
Primary Synovial Sarcoma, Head and neck lesion, Parapharyngeal tumor,
Abstract
Primary synovial sarcoma is an unusual tumor of the head and neck region and again primary parapharyngeal synovial sarcoma is a rare tumor entity. In our case a male patient, aged 27 years, presented with feeling of swelling and discomfort in the left parapharyngeal region. CT findings suggestive of soft tissue mass in prestylar region on left side. A transcervical excision of the tumor was performed and histopathological examination of H & E stained sections show biphasic tumor composed of epithelial and spindle cells components. The epithelial areas show glandular structure lined by cuboidal cells while spindle cells areas show densely cellular fascicles surroundings the epithelial cells. Immunohistochemistry shows strong positivity of cytokeratin, vimentin and weak positivity of S-100, BCl2, CD99 and SMA. Synovial sarcoma may be mistaken for other tumors due to its rarity. Treatment is essentially surgical, requiring wide margins; radiotherapy is usually associated. The value of chemotherapy has yet to be assessed.References
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10) Moorjani N. Peebles C, Gallagher P, Tsang G: pericardia synovial sarcoma. J card surg 2009 :24:349-51
2) Khademi B, Daneshbod Y, Negahban S, Daneshbod K, Kaviani M, Mohammadianpanah M, et al. Biphasic parapharyngeal synovial sarcoma: A cytologic and immunocytologic report of a case. CytoJournal 2006;3:20
3) Hazman MN, Jayarani JK, Kumar G, et al. Retropharyngeal synovial sarcoma rare location. Eur J Radiol Extra, 2008,68:103-6.
4) Corson JM, Weiss LM, Banks-Schlegel SP, Pinkus GS. Keratin proteins and carcinoembryonic antigen in synovial sarcomas: An immunohistochemical study of 24 cases. Hum Pathol 1984;15:615-21.
5) Lopes JM, Nesland JM, Reis-Filho JS, Holm R. Differential Ki67 and bcl-2 immunoexpression in solid-glandular and spindle cell components of biphasic synovial sarcoma: a double imunostaining assessment with cytokeratin and vimentin. Histopathology 2002;40:464-71.
6) Pappo AS, Fontanesi J, Luo X, Rao BN, Parham DM, Hurwitz C, et al. Synovial sarcoma in children and adolescents. The St Jude Children's Research Hospital experience. J Clin Oncol 1994;12:2360-6.
7) Arafah M, Zaidi SN. Poorly differentiated monophasic synovial sarcoma of the mediastinum. Indian J Pathol Microbiol 2011; 54:384-7
8) Kawata R, Terada T, Takenaka H, et al. Primary synovial sarcoma arising in the parotid region diagnosed by fluorescence in situ hybridization. Auris Nasus Larynx. 2008;35: 583-6
9) Funato M, Kaneko H, Ozeki M, et al. Pediatric synovial sarcoma of the right masseter muscle: a case report. Int J Pediatr Otorhino laryngol Extra. 2008;3:105-8.
10) Moorjani N. Peebles C, Gallagher P, Tsang G: pericardia synovial sarcoma. J card surg 2009 :24:349-51
Published
2014-09-28
Section
Case Report
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