Synovial Sarcoma of the Head and Neck

Objective To investigate the relationship between pathological diagnosis and clinical outcome of synovial sarcoma (SS) of head and neck. Method Thirty‐nine cases of SS in head and neck region from 1966 to 2011 were retrospectively studied by reviewing the pathological slices of the operative specimen and followed‐up from 1 to 16 years with a mean time of 4 years postoperatively. Results All patients were men aged from 8 to 66 years old with a mean age of 35 years and the disease demonstrated a predilection for lateral upper neck. Pathologically, 18 cases were biphasic, 17 cases were monophasic, and 3 cases were low‐differentiated SS. Four cases were proved by cytogenetic methods of either fluorescence in situ hybridization (FISH) or/and RT‐PCR. Six cases experienced repeated recurrence with the most up to 4 times operations after sole surgical approach. No lymphatic metastasis was observed during the 1‐ to 16‐year follow‐up. One patient developed scalp, arms, thoracic, and abdominal wall metastases during the postoperative 6‐year follow‐up, and one patient developed likely pulmonary metastatic foci but showed no growth and was not pathologically confirmed during the postoperative 2‐years’ follow‐up. Sixteen patients received adjuvant radiotherapy or chemotherapy. Nine patients died, but no death was directly associated with SS. Conclusion The locoregional control of SS seemed related more closely to the anatomy of the tumor location rather than pathological patterns. SS of head and neck is a special entity that has good prognosis, cytogenetic methods are recommended to be employed to ascertain the diagnosis in order to choose reasonable treatment protocols.