Transcervical Approach to Oropharyngeal Synovial Sarcoma: a Case Report

Abstract

Aim: Synovial sarcomas (SS) are malignant tumors rarely arising in the head and neck region. In most of these cases, the tumor arises in the cervical or hypopharyngeal region, and extremely rarely in the oropharynx. Case report: Herein, we report the case of a 22-year-old male oropharyngeal SS patient presented with breathing difficulty and dysphagia. The management plan included an emergency tracheostomy, followed shortly by transcervical resection of the oropharyngeal sarcoma tumor, the pectoralis major myocutaneous flap was used for pharyngeal reconstruction, followed by adjuvant radiotherapy resulting in more than 5 years disease-free survival. Conclusion: SS arising in the oropharynx are extremely rare. Transcervical resection coupled with adjuvant radiotherapy warrants enhanced locoregional control in advanced oropharyngeal cases.

Unveiling the Mystery: A Case Report on Oropharyngeal Synovial Sarcoma

“…Synovial sarcoma is a rare and aggressive subtype of sarcoma originating from mesenchymal cells [ 1 , 10 ]. While it can arise in various anatomical locations, its occurrence in the soft palate is extremely rare, with only a few reported cases in the literature [ 7 , 11 ].…”

“…These findings prompted the patient's referral to the emergency room (ER), leading to a workup that allowed for the diagnosis to be anticipated by three months, compared to the literature [ 9 ]. Considering the diagnosis of sarcomas, a delay in diagnosis is frequent due to their rarity and diverse clinical presentations, as shown in the clinical case by Algargaz et al [ 10 ].…”

“…Synovial sarcoma is a rare and aggressive subtype of sarcoma originating from mesenchymal cells [1,10].…”

“…The differential diagnosis includes benign soft tissue tumors, such as lipoma, as well as malignant tumors, such as sarcoma, metastatic carcinoma, melanoma, or lymphoma. The United Kingdom Department of Health has published criteria for soft tissue lesions that deserve an urgent referral: a soft tissue mass with a diameter superior to 5 cm, a painful lump, a lump that is increasing in size, a lump of any size that is deep to the muscle fascia, or recurrence of a lump after previous excision [ 10 ].…”