Multiple Recurrence of Primary Orbital Synovial Sarcoma: Report of Two Cases and Literature Review

Synovial sarcoma (SS) is typically an aggressive malignant soft tissue tumor that mostly affects adolescents and young adults. It extremely rare in orbit carries a high risk of recurrence metastasis, posing challenge to ophthalmologists diagnosing managing. We present two primary orbital synovial cases with unilateral exophthalmos limited motility. Both male patients underwent reoperation our hospital since recurrence; the pathologic diagnoses were biphasic type occult type, respectively. positive for EMA CK, SOX-9 INI-1 newly discovered immune markers. Fluorescence situ hybridization analysis (FISH) revealed translocation t (X; 18) (p11.2; q11.2) was detected case 1 but not 2. initially refused adjuvant therapy, developed multiple recurrences eventually died distant metastasis. provided clinical features, imaging findings, histopathology, treatments, outcomes these very cases, literature review, underlining timely diagnosis management.