Primary Synovial Sarcoma of the Thyroid: Challenges in Cytologic Diagnosis and Review of the Literature

Demirel, Dilaver; Erkul, Evren; Erkılıç, Suna; Issın, Gizem; Ramzy, Ibrahim

doi:10.1159/000507312

Cited by 5 publications

(2 citation statements)

References 23 publications

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“…According to different ultra structures, synovial sarcoma was divided into monophasic patterns and classic biphasic patterns (2). Synovial sarcoma in the head and neck region is relatively unusual, and primary synovial sarcoma in the thyroid gland is extremely rare with only 15 cases documented globally (3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13). Due to the rarity of the disease, challenges exist in clinical practice from diagnosis to follow-up.…”

Section: Introductionmentioning

confidence: 99%

Primary synovial sarcoma of the thyroid gland: a CARE compliant case report and literature review

Ren

Huang

et al. 2023

Front. Med.

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RationaleSynovial sarcoma is a subtype of soft tissue sarcoma. Synovial sarcoma in the head and neck region is relatively unusual. Primary synovial sarcoma of the thyroid gland (PSST) is first reported in 2003 by Inako Kikuchi. PSST is extremely rare with only 15 cases documented globally. PSST shows rapid disease progression and a relatively poor prognosis. However, diagnosis and therapy are challenging for clinical surgeons. In this article, we reported the 16th PSST case and reviewed the PSST cases globally for further clinical application.Patient concernsThe patient was referred to us because of gradually worsened dyspnea and dysphagia for 20 days. Physical examination showed a 5 × 4 cm mass with a clear boundary and good mobility. Contrast-enhanced ultrasonography (CEUS) and computed tomography (CT) showed a mass in the isthmus of the thyroid gland. The imageology diagnosis tends to be a benign thyroid nodule.DiagnosisAfter surgery, histopathology, immunohistochemistry, and fluorescence, in situ hybridization indicated the mass to be primary synovial sarcoma of the thyroid gland with no local and distant metastasis.InterventionsThe patient underwent total thyroidectomy and dissected the lymph nodes in the central compartment. This patient received postoperative chemotherapy (a combination of ifosfamide and epirubicin for five cycles). Patients tolerated chemotherapy well. No recurrence was found during the 9-month follow-up.LessonsAlthough PSST is an extremely rare disease, we should raise our awareness when we encounter a rapidly growing, cystic-solid mixed thyroid mass with neck compression symptoms to avoid misdiagnosis. Intraoperatively, surgeons should refine surgical procedures to avoid capsular rupture and tumor local implantation metastasis. Intraoperative frozen section pathology is necessary sometimes, especially when the diagnosis could not be established before surgery.

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Section: Introductionmentioning

confidence: 99%

Primary synovial sarcoma of the thyroid gland: a CARE compliant case report and literature review

Ren

Huang

et al. 2023

Front. Med.

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“…Primary synovial cell sarcoma of thyroid is exceedingly rare. To our knowledge, only 11 cases have been reported in the English literature [1] , [4] , [5] , [6] , [7] , [8] , [9] , [10] , [11] , [12] , [13] . Herein, we describe the twelfth case of primary synovial cell sarcoma of thyroid with a literature review.…”

Section: Introductionmentioning

confidence: 99%

Primary synovial sarcoma of thyroid gland: A case report and review of literature

Seyed-alagheband

Sharifian

Adeli

et al. 2021

International Journal of Surgery Case Reports

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Introduction and importance Synovial cell sarcoma (SS) is an extremely rare mesenchymal malignancy, representing nearly 10% of all soft-tissue sarcomas. These high-grade soft tissue sarcomas commonly arise in the para-articular regions of lower extremities. However, 15% of Synovial sarcomas has been described at Unusual locations, including head, neck, and trunk. Herein, we describe the twelfth case of primary synovial cell sarcoma of thyroid with a literature review. Case presentation A 43-year-old woman presented with complaint of a progressive neck mass for the last five-months. She developed with dysphagia and dyspnea nearly 2 months prior, without signs of hoarseness, and weight loss. Ultrasonography in which revealed a heterogeneous, hypervascularized thyroid mass. After total thyroidectomy immunohistochemistry was in favor of primary synovial cell sarcoma of thyroid. The diagnosis was confirmed via Molecular genetic analysis of the SYT-SSX fusion gene transcript using the RT- polymerase chain reaction method. Clinical Discussion: Primary thyroid SVS is an extremely rare malignancy with poor biological behavior. SVS has been known for its tendency to local and distal re-occurrence after a few years of treatment. SS can be classified into two subtypes of monophasic or biphasic based on the presence of mesenchymal and/or epithelial components. Accordingly, the most accurate diagnostic tool for SS is considered to be molecular genetic analysis for SYT/SSX fusion transcript. Conclusion Herein, we reported an extremely rare case of SVS of thyroid gland. These high-grade soft tissue sarcomas mainly present with an asymptomatic rapid growing neck mass. Unspecific clinical presentations and extreme rarity of this disorder, make the diagnosis of thyroid SVS very challenging. Due to paucity of data, there is not enough evidence to establish a reliable mortality rate. However, the prognosis of thyroid SVS seems unfavorable.

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Spindle Cells in Thyroid Aspirates

He,

Zhang,

2023

Thyroid FNA Cytology

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Primary Synovial Sarcoma of the Thyroid: Challenges in Cytologic Diagnosis and Review of the Literature

Cited by 5 publications

References 23 publications

Primary synovial sarcoma of the thyroid gland: a CARE compliant case report and literature review

Primary synovial sarcoma of the thyroid gland: a CARE compliant case report and literature review

Primary synovial sarcoma of thyroid gland: A case report and review of literature

Spindle Cells in Thyroid Aspirates

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