Poor outcome of comprehensive therapy in a case of laryngeal synovial sarcoma

Bao, Yang‐Yang; Wang, Quin-Ying; Zhou, Shi‐Ping; Zhao, Kui; Ruan, Ling-Xiang; Yao, Huaiying

doi:10.2478/raon-2013-0027

Cited by 6 publications

(4 citation statements)

References 20 publications

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“…All our patients underwent surgical resection. Upfront dissection of neck lymph nodes is not recommended, underlining the importance of distinguishing a synovial sarcoma from sarcomatoid carcinoma on a pre-operative biopsy [11]. The role of neoadjuvant chemotherapy remains questionable at present [13].…”

Section: Discussionmentioning

confidence: 99%

“…Regarding adjuvant therapies, Bilgic et al treated an operated case of laryngeal synovial sarcoma with distant metastases to lung with post-op radiotherapy followed by chemotherapy, which proved to be effective and the metastatic nodules disappeared [10]. Bao et al reported the management of local recurrence and distant metastases of a laryngeal synovial sarcoma case with radiation and chemotherapy; the patient however, succumbed to the disease [11]. Thus, the role of adjuvant chemotherapy and radiotherapy is controversial, but these treatment modalities can be offered to patients with incomplete resection and distant metastases.…”

Section: Discussionmentioning

confidence: 99%

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Primary synovial sarcoma of larynx: Clinicopathologic features of an enigmatic entity posing diagnostic and therapeutic challenges

Kakkar¹,

Banerjee²,

Kane³

et al. 2016

Otorhinolaryngol Head Neck Sur

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Synovial Sarcoma (SS) is an aggressive, yet a relatively chemosensitive malignant mesenchymal neoplasm, which displays variable epithelial differentiation, and typically occurs in adolescents and young adults, most frequently in the lower extremities. SS is also reported at certain unconventional sites, where its inherent morphologic heterogeneity and overlapping histopathologic features with certain tumors indigenous to that site can lead to a diagnostic dilemma. Presently, the diagnostic gold standard of a synovial sarcoma is demonstration of the characteristic t(X;18) (p11.2; q11.2) translocation, resulting in SYT-SSX fusion, especially in cases occurring at unconventional sites. Larynx is one of the rarely reported sites for a synovial sarcoma, with only 28 such cases reported till date, including only six cases confirmed by molecular testing.We report three cases of primary laryngeal synovial sarcoma which presented a diagnostic challenge and were confirmed by molecular testing. Although rare, SYNOVIAL SARCOMA should be kept as a differential diagnosis of spindle cell neoplasms and biphasic tumors occurring in the larynx. In view of the difference in treatment and patient outcome from the relatively more frequently occurring tumors in the larynx, such as sarcomatoid carcinoma and minor salivary gland neoplasms, its accurate diagnosis with molecular testing in such cases is crucial.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Primary synovial sarcoma of larynx: Clinicopathologic features of an enigmatic entity posing diagnostic and therapeutic challenges

Kakkar¹,

Banerjee²,

Kane³

et al. 2016

Otorhinolaryngol Head Neck Sur

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“…One case of advanced metastatic disease published in 2013 reported on the use of the immunotherapeutic agents nimotuzumab and cetuximab, both monoclonal antibodies against epidermal growth factor receptor. 25…”

Section: Treatmentmentioning

confidence: 99%

Laryngeal Synovial Sarcoma: A Systematic Review of the Last 40 Years of Reported Cases

et al. 2019

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Primary laryngeal synovial sarcoma is an extremely rare tumor predominantly affecting young adults. There are currently no well-defined guidelines to direct investigation and management, and treatment is largely based on what is known for synovial sarcoma of the upper and lower limbs. This PROSPERO-registered study aims to review the diagnostic methods, treatment regimens, and survival outcomes for patients with synovial sarcoma of the larynx. A systematic search of databases Medline, Embase, SCOPUS, and Web of Science was undertaken in December 2017. The literature search identified 1031 potentially relevant studies, and after the deletion of duplicates and excluded papers, 98 full-text articles were screened. A total of 39 cases were reviewed from 32 studies in the data extraction. The average age at the time of laryngeal synovial sarcoma diagnosis was 32 years (range, 11-79 years). In all cases (n ¼ 39), patients underwent wide surgical excision, with 20 patients requiring a partial or total laryngectomy. A total of 18 patients received adjuvant and 3 received neoadjuvant radiotherapy. Chemotherapy was used in 10 cases, with ifosfamide the most frequently used agent. There was considerable variability in the order and combinations of the abovementioned treatments. No clinicopathologic factors or treatment regimens were associated with improved overall survival or lower rate of recurrence. There is a paucity of literature and heterogeneity in clinical approaches to this highly aggressive sarcoma. Reporting of cases must be standardized and formal guidelines must be established to guide clinical management.

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“…Adjuvant chemotherapy was administered to 12 adult patients (13.8%) and had no impact on survival [16]. Only few reports (case reports of adult patients with initially localized as well as initially metastatic SS) exist considering OS [19,20,21,22,23]. …”

Section: Introductionmentioning

confidence: 99%

Initially Localized Synovial Sarcoma in Adults: A Retrospective Single-Center Analysis of 26 Patients Registered at the Department of Oncology, University of Vienna between 2004 and 2013

et al. 2014

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Background: Synovial sarcoma is a rare subgroup of all soft-tissue sarcomas. The aim of this retrospective single-center analysis was to investigate the outcome of patients with initially localized disease. Patients and Methods: Twenty-six patients were enrolled in this retrospective single-center analysis. Baseline characteristics, treatment and outcome were evaluated. Results: In 13 patients (50%), the tumor was located in the lower extremity and in 4 patients (15%) in the upper extremity. Surgical resection was done in all but 2 patients (92%). Re-resection was done in 7 patients (27%). Fourteen patients (54%) received adjuvant chemotherapy. After a median follow-up of 23.3 months (range: 2.6-150.3), median disease-free survival was not reached at the time of analysis. Eight patients (31%) relapsed after initial therapy. Surgery was done in 2 patients, amputation in 1 patient, palliative chemotherapy was administered in 3 and radiation therapy in 2 patients. Median overall survival (OS) for all patients was not reached at the time of analysis. The estimated 5-year OS rate was 62%. Conclusion: Patients with initially localized synovial sarcoma who were included in this retrospective single-center analysis have an estimated 5-year OS rate of 62%.

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Poor outcome of comprehensive therapy in a case of laryngeal synovial sarcoma

Cited by 6 publications

References 20 publications

Primary synovial sarcoma of larynx: Clinicopathologic features of an enigmatic entity posing diagnostic and therapeutic challenges

Primary synovial sarcoma of larynx: Clinicopathologic features of an enigmatic entity posing diagnostic and therapeutic challenges

Laryngeal Synovial Sarcoma: A Systematic Review of the Last 40 Years of Reported Cases

Initially Localized Synovial Sarcoma in Adults: A Retrospective Single-Center Analysis of 26 Patients Registered at the Department of Oncology, University of Vienna between 2004 and 2013

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