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Al Hayek M, Yousfan A. Monophasic synovial sarcoma in the temporomandibular joint region: A case report and review of the literature. Int J Surg Case Rep 2023; 105:107998. [PMID: 36966715 PMCID: PMC10066519 DOI: 10.1016/j.ijscr.2023.107998] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Revised: 03/16/2023] [Accepted: 03/17/2023] [Indexed: 03/29/2023] Open
Abstract
INTRODUCTION AND IMPORTANCE Synovial sarcoma is a malignant neoplasm that arises from soft tissue and makes up 5 % to 10 % of all types of sarcoma. It is most common between the ages of 15 and 40; it typically develops in the lower extremities; just 3 % to 10 % of cases arise in the head and neck. The usual main areas in the head and neck are the parapharyngeal, hypopharyngeal, and paraspinal. CASE PRESENTATION An 18-year-old woman presented with a painful mass in the left pre-auricular area. CLINICAL DISCUSSION Magnetic resonance imaging showed a well-defined lobular mass localized superior and anterior to the left ear. Incisional biopsy showed spindle cell sarcoma. A preauricular incision was done to remove the tumor with the superficial lobe of the parotid gland during the procedure, and histological examination revealed a high-grade spindle cell sarcoma the differential diagnosis included a monophasic synovial sarcoma. Immunohistochemistry was done for a full evaluation and the panel supported diagnosing a monophasic synovial sarcoma. CONCLUSION Synovial sarcoma is a malignant tumor that is rare to develop in the temporomandibular region, which makes it a significant challenge to diagnose and differentiate it from other lesions, it should be considered in all patients with a mass in this region. The cornerstone to identify synovial sarcoma is Immunohistochemistry (IHC), and molecular genetic analyses. Total surgical excision, with or without radiation and chemotherapy, is currently the best option for treatment. We present a review of the literature after the case presentation.
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Affiliation(s)
- Mohammad Al Hayek
- Faculty of Medicine, Damascus University, Damascus, Syrian Arab Republic.
| | - Abdulmajeed Yousfan
- Department of Otolaryngology, Al Mouwasat University Hospital, Damascus University, Damascus, Syrian Arab Republic
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Quan H, Sreekissoon S, Wang Y. Synovial sarcoma of the head and neck: A review of reported cases on the clinical characteristics and treatment methods. Front Cell Dev Biol 2022; 10:1077756. [PMID: 36684451 PMCID: PMC9853006 DOI: 10.3389/fcell.2022.1077756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2022] [Accepted: 12/12/2022] [Indexed: 01/08/2023] Open
Abstract
Synovial sarcoma (SS) is a high-grade soft-tissue sarcoma that occurs predominantly in older children and young adults in their thirties. It is usually very challenging to diagnose and treat synovial sarcoma in the head and neck region. The purpose of this review is to investigate the clinical manifestations and different treatment methods in the management of primary synovial sarcoma of the head and neck. HNSS has an aggressive nature and poor prognosis. Surgical resection, radiotherapy, and chemotherapy are the primary treatment methods. Typically, surgical resection with negative margins remains the foundation of therapy, which is not very easily achieved in the head and neck due to its complex anatomical structure and the presence of many blood vessels and nerves. However, synovial sarcoma has a high recurrence rate, so aggressive management and close follow-up are warranted for the optimal outcome.
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Affiliation(s)
- Hongzhi Quan
- Department of Oral Maxillofacial Surgery, Xiangya Stomatological Hospital and School of Stomatology, Central South University, Changsha, Hunan, China
| | - Senjeet Sreekissoon
- Department of Oral Maxillofacial Surgery, Xiangya Stomatological Hospital and School of Stomatology, Central South University, Changsha, Hunan, China
| | - Yan Wang
- School and Hospital of Stomatology, Wenzhou Medical University, Wenzhou, Zhejiang, China
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3
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Synovial sarcoma of the head & neck: A review of reported cases in the literature. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2020; 122:505-510. [PMID: 33301946 DOI: 10.1016/j.jormas.2020.12.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Revised: 11/24/2020] [Accepted: 12/01/2020] [Indexed: 11/22/2022]
Abstract
Synovial sarcoma is a high-grade malignancy that seldom manifests in the head and neck. The purpose of this paper is to provide a comprehensive review of the existing literature on primary HNSS. This review study includes case reports, case series and retrospective cohort studies on primary HNSS published in the English language. All cases identified via PubMed were analyzed individually. Articles were included according to specified eligibility criteria. The total number of cases analyzed was 243 (91 case reports, 53 cases from 16 case series, and 99 cases from 8 retrospective cohort studies). The average age at the time of HNSS diagnosis was 33.5 years. The ratio of male-to-female was 1.64:1. The most frequently occurring histologic subtype was biphasic (59.2%). The most common location was the neck. Hoarseness was the most common presenting symptom. Almost all patients (98.3%) underwent surgical excision. 55.6% of patients received adjuvant radiotherapy. A smaller number of patients (30.7%) received adjuvant chemotherapy. 60.3% of patients were alive with no evidence of disease at follow-up while 28.0% of patients died of HNSS at follow-up. The average follow-up period was 52.0 months. Synovial sarcoma is a rare head and neck malignancy. Surgical excision with adjuvant radiation is the most frequently employed treatment modality. Regardless of treatment modality, the prognosis of the tumor is guarded.
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Biphasic synovial Sarcoma with extensive calcification in the temporomandibular joint region: A rare case report and literature review. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2020; 121:592-598. [DOI: 10.1016/j.jormas.2020.02.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/13/2019] [Revised: 12/11/2019] [Accepted: 02/12/2020] [Indexed: 11/21/2022]
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Schlund M, Roland-Billecart T, Aubert S, Nicot R. [Tumors affecting the temporomandibular joint - a literature review]. Bull Cancer 2020; 107:1186-1198. [PMID: 33059872 DOI: 10.1016/j.bulcan.2020.05.015] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Revised: 05/19/2020] [Accepted: 05/27/2020] [Indexed: 10/23/2022]
Abstract
Benign and malign tumors can affect the temporomandibular joint (TMJ) as any other articulation. Nevertheless, TMJ tumors are rare and mostly benign. Their clinical expression is varied including symptomatology similar to TMJ dysfunctional disorders, otologic or neurologic pathologies. In some cases, they remain totally asymptomatic. Hence, diagnosis is difficult since the symptomatology can be misleading with TMJ dysfunctional disorders or otologic disorders wrongly diagnosed. There is thus frequently a long delay between symptoms onset and diagnosis. The great variety of TMJ lesions explains the wide range of possible treatment modalities, mostly based on surgery. We provide here a review of the lesions originating from the TMJ. Tumoral or cystic mandibular lesion affecting the TMJ through local extension will not be discussed. Osteoma, osteoid osteoma, osteoblastoma, chondroma, osteochondroma, chondroblastoma, tenosynovial giant cell tumors, giant cell lesions, non-ossifying fibroma, hemangioma, lipoma or Langerhans cell histiocytosis are all possible diagnosis among the benign tumors found in the TMJ. Pseudotumors include synovial chondromatosis and aneurysmal bone cyst. Finally, malign tumors of the TMJ include mainly sarcomas (osteosarcoma, chondrosarcoma, synovial sarcoma, Ewing sarcoma, and fibrosarcoma), but also multiple myeloma and secondary metastases. We will review the clinical, radiological and histological aspects of each of these lesions. The treatment and the recurrence risk will also be discussed.
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Affiliation(s)
- Matthias Schlund
- University Lille, CHU de Lille, service de chirurgie maxillo-faciale et stomatologie, U1008 - Controlled Drug Delivery Systems and Biomaterial, Inserm, 59000 Lille, France.
| | - Thomas Roland-Billecart
- University Lille, CHU de Lille, service de chirurgie maxillo-faciale et stomatologie, 59000 Lille, France
| | - Sébastien Aubert
- University Lille, CHU de Lille, institut de pathologie, 59000 Lille, France
| | - Romain Nicot
- University Lille, CHU de Lille, service de chirurgie maxillo-faciale et stomatologie, U1008 - Controlled Drug Delivery Systems and Biomaterial, Inserm, 59000 Lille, France
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Hamza A, Gidley PW, Learned KO, Hanna EY, Bell D. Uncommon tumors of temporomandibular joint: An institutional experience and review. Head Neck 2020; 42:1859-1873. [PMID: 32040228 DOI: 10.1002/hed.26106] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2019] [Revised: 12/31/2019] [Accepted: 01/28/2020] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND The temporomandibular joint (TMJ) harbors a myriad of pathologic alterations including arthritides and benign and malignant neoplasms. METHODS Herein, we describe our institutional experience of some uncommon and unusual synovial pathologies of the TMJ along with a review of literature. We searched through the archives of department of pathology and institutional electronic medical record for specimens of TMJ between 1999 and 2019. Hematoxylin and eosin slides were reviewed and data (final diagnosis, age, gender, clinical presentation, tumor size, treatment modality, recurrence, and vital status) were collected. RESULTS A total of seven cases were identified including four cases of synovial chrondromatosis; and one case each of tenosynovial giant cell tumor, localized type, tenosynovial giant cell tumor, diffuse type, and synovial sarcoma. CONCLUSIONS The article emphasizes on the clinical, radiologic, pathologic, and molecular features of these uncommon entities. The differential diagnosis of each entity is also discussed. Current updates in the management are also reviewed.
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Affiliation(s)
- Ameer Hamza
- Department of Pathology, University of Texas M. D. Anderson Cancer Center, Houston, Texas
| | - Paul W Gidley
- Department of Head and Neck Surgery, University of Texas M. D. Anderson Cancer Center, Houston, Texas
| | - Kim O Learned
- Department of Neuroradiology, University of Texas M. D. Anderson Cancer Center, Houston, Texas
| | - Ehab Y Hanna
- Department of Head and Neck Surgery, University of Texas M. D. Anderson Cancer Center, Houston, Texas
| | - Diana Bell
- Department of Pathology, University of Texas M. D. Anderson Cancer Center, Houston, Texas.,Department of Head and Neck Surgery, University of Texas M. D. Anderson Cancer Center, Houston, Texas
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Yamazaki H, Suzuki T, Denda Y, Nakanishi Y, Uchibori M, Kojima R, Kondo Y. Mandibular pain, trismus, and weight loss in a 75-year-old man. Oral Surg Oral Med Oral Pathol Oral Radiol 2018; 126:451-456. [PMID: 29396313 DOI: 10.1016/j.oooo.2017.12.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2017] [Revised: 11/24/2017] [Accepted: 12/14/2017] [Indexed: 11/19/2022]
Affiliation(s)
- Hiroshi Yamazaki
- Department of Oral and Maxillofacial Surgery, Tokai University Oiso Hospital, Kanagawa, Japan.
| | - Takatsugu Suzuki
- Department of Oral and Maxillofacial Surgery, Tokai University School of Medicine, Kanagawa, Japan
| | - Yuya Denda
- Department of Oral and Maxillofacial Surgery, Tokai University School of Medicine, Kanagawa, Japan
| | - Yasuhiro Nakanishi
- Department of Pathology, Tokai University School of Medicine, Kanagawa, Japan
| | - Masahiro Uchibori
- Department of Pathology, Tokai University School of Medicine, Kanagawa, Japan
| | - Rena Kojima
- Department of Oral and Maxillofacial Surgery, Tokai University School of Medicine, Kanagawa, Japan
| | - Yusuke Kondo
- Department of Pathology, Tokai University School of Medicine, Kanagawa, Japan
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Wushou A, Miao XC. Tumor size predicts prognosis of head and neck synovial cell sarcoma. Oncol Lett 2014; 9:381-386. [PMID: 25435996 PMCID: PMC4247063 DOI: 10.3892/ol.2014.2634] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2014] [Accepted: 09/26/2014] [Indexed: 12/20/2022] Open
Abstract
Head and neck synoviosarcoma (HNSS) is uncommon. To the best of our knowledge, the specific clinicopathological characteristics, treatment outcome and prognostic factors of HNSS were uninvestigated at the time of writing, so a meta-analysis was performed. An online data collection was carried out using PubMed and Google Scholar. Studies that reported primary HNSS and the treatment, follow-up time and outcome were chosen for the present study. In total, 93 cases from 26 studies were included for analysis. The study sample consisted of 55 males and 38 females and the median age was 32.1 years (range, 4-76 years). The median follow-up period was 62.1 months (range, 1-373 months). The tumor size was correlated with local recurrence and metastasis of HNSS, as well as with mortality (P=0.001, P<0.0001 and P<0.0001, respectively). The three-year, five-year and 10-year survival rates were 82.1, 80.4 and 78.2% for treatment with surgery alone, and 88.5, 85.5 and 82% for treatment with surgery plus radiotherapy, respectively. A significant tumor size-dependent difference was found between the overall survival (OS) rates (P<0.0001), as tumors that were >5.0 cm in diameter were associated with a worse OS rate (hazard ratio, 6.460; 95% confidence interval, 206-18.917; P=0.001). The tumor size was found to be an independent adverse prognostic factor for the OS of HNSS patients. In conclusion, surgical excision is a mainstream treatment of HNSS and post-operative adjuvant radiotherapy improves the OS rate of HNSS patients.
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Affiliation(s)
- Alimujiang Wushou
- Cancer Research Institute, Fudan University Shanghai Cancer Center; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, P.R. China
| | - Xin-Chao Miao
- Department of Oral and Maxillofacial Surgery, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, P.R. China
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Rapidis AD. Sarcomas of the head and neck in adult patients: current concepts and future perspectives. Expert Rev Anticancer Ther 2014; 8:1271-97. [DOI: 10.1586/14737140.8.8.1271] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
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Oukabli M, Chibani M, Ennouali H, Hemmaoui B, Albouzidi A. [Temporomandibular joint primitive tumors and pseudo tumors]. ACTA ACUST UNITED AC 2013; 114:9-14. [PMID: 23711211 DOI: 10.1016/j.revsto.2012.12.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2012] [Revised: 08/30/2012] [Accepted: 12/16/2012] [Indexed: 11/30/2022]
Abstract
The temporomandibular joint (TMJ) can be the site of bone, cartilaginous, or synovial tumors. There is no well-defined histological classification. We listed all benign tumors, malignant primitive tumors, and rare pseudo tumors of the TMJ. We provide a list to help for the diagnosis and the differential diagnosis of non-tumoral lesions by far the most frequent.
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MESH Headings
- Bone Cysts, Aneurysmal/epidemiology
- Bone Cysts, Aneurysmal/pathology
- Carcinoma, Giant Cell/epidemiology
- Carcinoma, Giant Cell/pathology
- Chondromatosis, Synovial/epidemiology
- Chondromatosis, Synovial/pathology
- Diagnosis, Differential
- Histiocytosis, Langerhans-Cell/epidemiology
- Histiocytosis, Langerhans-Cell/pathology
- Humans
- Jaw Cysts/classification
- Jaw Cysts/epidemiology
- Jaw Cysts/pathology
- Mandibular Neoplasms/classification
- Mandibular Neoplasms/epidemiology
- Mandibular Neoplasms/pathology
- Sarcoma/classification
- Sarcoma/epidemiology
- Sarcoma/pathology
- Synovitis, Pigmented Villonodular/epidemiology
- Synovitis, Pigmented Villonodular/pathology
- Temporomandibular Joint/pathology
- Temporomandibular Joint Disorders/classification
- Temporomandibular Joint Disorders/epidemiology
- Temporomandibular Joint Disorders/pathology
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Affiliation(s)
- M Oukabli
- Hôpital militaire d'instruction Mohamed V, Hay Riad, faculté de medecine et de pharmacie, 10000 Rabat, Maroc.
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Synovial Sarcoma of the Masticator Space: Report of a Case. J Oral Maxillofac Surg 2011; 69:e482-7. [DOI: 10.1016/j.joms.2011.03.018] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2011] [Revised: 03/13/2011] [Accepted: 03/14/2011] [Indexed: 11/23/2022]
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Synovial Sarcoma of the Nasal Cavity. A Case Report. ACTA OTORRINOLARINGOLOGICA ESPANOLA 2011. [DOI: 10.1016/j.otoeng.2010.02.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Pontes HA, Pontes FS, Silva BT, Lima JF, Kato AM, Lameira AG, Silva BS, Pinto DS. A diffuse swelling of the left side of the face. ACTA ACUST UNITED AC 2010; 110:685-90. [PMID: 21112530 DOI: 10.1016/j.tripleo.2010.08.023] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2010] [Revised: 08/17/2010] [Accepted: 08/22/2010] [Indexed: 11/28/2022]
Affiliation(s)
- Hélder A Pontes
- João de Barros Barreto University Hospital, Federal University of Pará, Pará, Brazil
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[Synovial sarcoma of the nasal cavity. A case report]. ACTA OTORRINOLARINGOLOGICA ESPANOLA 2010; 62:246-8. [PMID: 20466354 DOI: 10.1016/j.otorri.2010.02.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2009] [Revised: 02/04/2010] [Accepted: 02/14/2010] [Indexed: 01/02/2023]
Abstract
Synovial sarcoma is a rare tumour found in soft tissue; it is a mesenchymal spindle cell tumour that is not related to the synovial membrane. This tumour has a low incidence, the most frequent place of occurrence being the lower extremities in young adults. Synovial sarcoma of the head and neck accounts for 3-5% of sarcomas in this anatomical region. The treatment of choice for synovial sarcoma of the head and neck is complete surgical excision of the tumour mass followed by adjuvant radiotherapy.
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Shintaku WH, Venturin JS, Yepes JF. Application of advanced imaging modalities for the diagnosis of metastatic adenocarcinoma of the lungs in the temporomandibular joint. ACTA ACUST UNITED AC 2009; 107:e37-41. [DOI: 10.1016/j.tripleo.2009.02.027] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2009] [Accepted: 02/22/2009] [Indexed: 12/25/2022]
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