Synovial sarcoma: case report

ABSTRACT Introduction: Synovial sarcomas are rare and aggressive neoplasms located in the head and neck region and usually occurs in young adults. Presentation of case: This report presents a case of synovial sarcoma in a 15-year-old male patient who sought medical treatment for painful symptoms and associated dysphagia. The lesion was nodular, extensive, localized in the parotid region, and extended to the left cervical region. The patient was treated in a referral hospital with a treatment protocol that initially included chemotherapy for six months and surgery to attempt to excise the lesion, but the surgery was ineffective because removal could have damaged important vital structures. The Computed Tomography scan showed a hypodense area with diffuse growth and no involvement of the facial bones and the histopathological analysis revealed pleomorphic and oval spindle cells with rounded epithelial cells that formed nests surrounded by fibrous tissue. The Immunohistochemistry analysis was conclusive for the diagnosis of a high-grade SS in the parotid and left cervical regions. The medical team opted for palliative treatment with cervical radiotherapy. The patient remained hospitalized for four months after the surgery and died after 15 months since the diagnosis for compromise of airway by fast tumor growth. Conclusion: The synovial sarcoma, when diagnosed late may reduce the survival of patients because of the complications that tumor growth can bring to the prognosis and quality of life.

摘要
引言：滑膜肉瘤（Synovial Sarcoma）是一类罕见且侵袭性较强的肿瘤，多发生于头颈部区域，常见于青年群体。
病例报告：本报告记述一例15岁男性滑膜肉瘤患者，其因疼痛症状伴吞咽困难就医。病灶呈结节状、范围广泛，累及腮腺区域并延伸至左侧颈部。患者于转诊医院接受治疗，初始治疗方案包含为期6个月的化疗与病灶切除手术，但因切除操作可能损伤重要生命结构，手术未能成功实施。计算机断层扫描（Computed Tomography，CT）显示病灶为弥漫性生长的低密度区域，未累及面骨；组织病理学分析可见多形性卵圆形梭形细胞，与被纤维组织包绕的圆形上皮细胞形成巢状结构。免疫组织化学检测结果明确诊断为腮腺及左侧颈部高级别滑膜肉瘤。医疗团队选择颈部放射治疗作为姑息治疗方案。患者术后住院时长4个月，确诊15个月后因肿瘤快速生长导致气道受压而死亡。
结论：滑膜肉瘤若诊断延迟，可因肿瘤生长引发的并发症影响预后与生活质量，进而缩短患者生存期。