This is the first reported Australian case of synovial sarcoma of the pharynx. A 29-yearold man had a large hypopharyngeal mass excised and received radiotherapy and chemotherapy. No recurrence was seen 12 months later. Clinical record A 29-year-old man presented to the emergency department with stridor and a background of progressive globus sensation, loud snoring and worsening dysphagia over 2 years. He had not suffered weight loss, and past medical history was otherwise unremarkable. Flexible endoscopy examination revealed a well circumscribed, encapsulated tumour arising from the left lower lateral wall of the oropharynx and hypopharynx, and from the left arytenoid on its posterior aspect (Box 1). Computed tomography (CT) scanning revealed a 3  4.1 cm soft tissue mass arising from the left pharyngeal wall just inferior to the tonsillar fossa (Box 2). Endoscopic laser resection (microlaryngoscopy) was carried out with several scopes, including a bivalved speculum and a Boyle-Davis gag to gain full exposure. The capsule was broken at its deep aspect; however, macroscopic clearance was achieved with dissection down to healthy muscle. The patient made an uneventful recovery and was discharged on Day 3. Histopathological analysis revealed a well circumscribed tumour that measured 8  4  3 cm and was composed of relatively uniform spindle cells showing frequent mitotic activity. The tumour showed focal necrosis and focal calcification. The posterior surface was raw, suggesting incomplete margins. The cells stained positively for vimentin and CD99, and occasional cells stained positively for cytokeratin AE1/AE3 and epithelial membrane antigen (EMA).