Synovial cell sarcoma: diagnosis, treatment, and outcomes.
OBJECTIVE
Synovial cell sarcoma is a mesenchymal tumor predominantly of the lower extremities. Three percent of cases arise in the head and neck region. It is thought that head and neck synovial sarcoma has a better prognosis than tumors of the extremities. Our experience has demonstrated aggressive behavior of this neoplasm in the head and neck. This compelled us to compare our experience with other studies.


METHODS
Retrospective chart review.


METHODS
We obtained the records of patients diagnosed with head and neck synovial sarcoma from the Tumor Registry of the University of Louisville School of Medicine (Louisville, KY) and affiliated hospitals for data compiled between January 1990 and December 2000. Data on patient demographics, clinical findings and symptoms, histological findings, treatment, extent of disease, recurrence, and survival were recorded. The literature was reviewed identifying reports of synovial cell sarcoma.


RESULTS
Five consecutive patients with synovial cell sarcoma were assessed at our facility. The median patient age was 28.2 years. All of the patients underwent an aggressive primary surgical excision followed by irradiation. All patients received chemotherapy after recurrence. Four of the five patients had local recurrence, and all five of the patients developed distant metastases. Three of the patients have died, and two are alive with evidence of disease. Novel sites are reported including the ethmoid sinus and the parotid gland. This group demonstrated a 40% 5-year overall survival, which was lower than the 60% 5-year survival reported in the literature for all sites.


CONCLUSIONS
Synovial cell sarcoma of the head and neck is a disease of young people and carries a poor prognosis. The aggressive nature of the disease may require modification of accepted treatment modalities and sequence.
Kartha
Swapna S
SS
Department of Surgery, University of Louisville, School of Medicine, Kentucky 40292, USA.
Bumpous
Jeffrey M
JM
D000328:Adult; D003131:Combined Modality Therapy; D005260:Female; D006258:Head and Neck Neoplasms / Q000175:diagnosis* / Q000628:therapy*; D006801:Humans; D008297:Male; D011379:Prognosis; D012189:Retrospective Studies; D013584:Sarcoma, Synovial / Q000175:diagnosis* / Q000628:therapy*; D015996:Survival Rate; D016896:Treatment Outcome