Primary synovial sarcoma of mandibular gingiva: An exceedingly rare case report

Abstract

Synovial sarcoma is a soft tissue sarcoma that rarely occurs in the oral cavity and the most common site is the tongue. Synovial sarcoma of the oral cavity mostly presents as a slowly growing, painless, and deeply seated mass. Radical surgical excision with negative margins is the treatment of choice and adjuvant radiotherapy is advised. This report presents a 48-year-old male patient with a rapidly growing mandibular gingival mass with underlying alveolar bone destruction. Incisional biopsy was done, and the specimen was stained with Hematoxylin and Eosin. Microscopic sections showed fascicles of proliferated spindle-shaped cells with plump nuclei that invaded the surrounding skeletal muscles. The lesion was positive for Vimentin, CD99, CK and Bcl-2 in immunohistochemistry. The diagnosis of monophasic synovial sarcoma was made, and radical surgical excision was performed. Due to the paucity of synovial sarcoma in the oral region, the information about appropriate treatment for this sarcoma is limited. The knowledge about this rare entity and microscopic characteristics are important and help to have a proper diagnosis and improved treatment plan.