Biphasic synovial sarcoma in the cervical spine: Case report

Abstract

Synovial sarcoma is a rare malignant neoplasm of soft tissue that typically arising near large joints of the upper and lower extremities in young adult males. Only 3% of these neoplasms have been found to arise in the head and neck region. To our knowledge, there are limited reports in the literature of this neoplasm in the cervical spine.A case of biphasic synovial sarcoma of the cervical spine is reviewed. A 29 year-old male presented with pain on the left side of the cervical spine. Physical examination revealed a global loss of cervical motion and large, palpable mass in the left paravertebral area. The long-delayed Magnetic Resonance (MR) scan revealed a soft tissue mass measuring 8.3 centimeters (cm) × 5.7 cm that was surgically removed. A malignant biphasic synovial sarcoma was diagnosed on pathologic examination.The clinical and imaging findings of an atypically located synovial sarcoma are reviewed. This case report emphasizes the consequences of a limited differential diagnosis, prolonged treatment and the failure to perform timely diagnostic imaging in the presence of a paraspinal mass.

Surgical management and outcome of synovial sarcoma in the spine

“…In a previous report, the duration between the onset of symptoms and start of treatment could be longer than 10 years [ 20 ]. For spinal patients, numbness or weakness of the extremities and urinary or bowel dysfunction caused by nerve root irritation or spinal cord compression are commonly seen [ 21 – 23 ]. In our series, 81.25% patients had varying degrees of neurological deficits and almost all patients had pain in tumour sites.…”

Monophasic Synovial Sarcoma of the Lower Eyelid: Rare Tumor involving Rare Site

“…5 Majority of these tumors are associated with chromosomal translocation between chromosome 18 and X that results in the fusion of the SYT genes located on chromosome 18 and the SSX-1 or SSX-2 gene on chromosome X. 6 Synovial sarcomas in head and neck region are rare accounting for 6 to 8% of all synovial sarcomas. Most 7 Immunohistiochemistry helps in differentiating other poorly differentiated sarcomas, neurogenic sarcoma, and hemangiopericytoma.…”

“…Head and neck synovial sarcomas are aggressive tumors, but some have better prognosis, probably due to early detection. 6 Five-year survival rate is around 25 to 55%, with high chances of metastasis to lungs and bones. 10…”

Synovial sarcoma of cervical intervertebral foramen: A rare cause of brachial weakness

“…Magnetic resonance imaging (MRI) of cervical spine revealed a well-defined oval, lobulated, extramedullary mass lesion (1.2 × 3.1 × 1.5 cm) in C6-C7 intervertebral foramen. [7][8][9] However, in these cases, a large heterogenous tumor with bone destruction and predominant paravertebral location were the prominent features. The lesion was hyperintense on T2 weighted and hypointense on T1-weighted sequences [Figures 1a and 1b].…”