title: Synovial sarcoma of the larynx treated by supraglottic laryngectomy: case report and literature review.
abstract: We describe a case of synovial sarcoma of the larynx, and we discuss the use of fluorescence in situ hybridization (FISH) in confirming the diagnosis. The patient was a 21-year-old woman who presented with a recurrence of a previously resected supraglottic tumor of the aryepiglottic folds. A horizontal supraglottic laryngectomy was performed, and the 0.5-cm tumor was resected. Histopathologic study suggested that it was a biphasic malignant tumor compatible with a synovial sarcoma. The diagnosis of synovial sarcoma was confirmed by FISH immunohistochemistry with the use of an SYT break-apart probe. The patient recovered satisfactorily, but at follow-up 5 years and 4 months later, tumoral activity was evident in the left side of the neck. A biopsy found that 5 lymph nodes contained a metastasis of the synovial sarcoma. Again, a bilateral neck dissection was performed, and it revealed that 16 of 16 right-side nodes and 36 of 36 left-side nodes were negative. Two months later, the patient received 46 Gy of radiotherapy in 23 sessions. She remained free of disease during 2 more years of follow-up. Synovial sarcoma of the larynx is a rare entity. Organ preservation seems to be indicated in these cases. The histologic diagnosis may be difficult. In this case, the identification of a genetic mutation corroborated the diagnosis.
authors.affiliation: Department of Head and Neck Surgery, Instituto Nacional de Cancerología, México City, México. kauauhyama@yahoo.com.mx
authors.forename: Kuauhyama
authors.initials: K
authors.lastname: Luna-Ortiz
authors.forename: Ana María
authors.initials: AM
authors.lastname: Cano-Valdez
authors.forename: Isabela Werneck
authors.initials: IW
authors.lastname: da Cunha
authors.forename: Adalberto
authors.initials: A
authors.lastname: Mosqueda-Taylor
mesh_terms: D005260:Female; D006801:Humans; D017404:In Situ Hybridization, Fluorescence; D007822:Laryngeal Neoplasms / Q000175:diagnosis* / Q000532:radiotherapy / Q000601:surgery; D007825:Laryngectomy / Q000379:methods; D008207:Lymphatic Metastasis / Q000532:radiotherapy; D037981:Neck Dissection; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis* / Q000532:radiotherapy / Q000601:surgery; D013584:Sarcoma, Synovial / Q000175:diagnosis* / Q000532:radiotherapy / Q000601:surgery; D055815:Young Adult