Adult Synovial Sarcoma of the head and neck: An institutional study and literature review

Background: Synovial Sarcoma of the head and neck is a rare, aggressive malignancy with a poor prognosis. This study reports the clinical course and management of 5 patients presenting with synovial sarcoma of the head and neck at our institution to evaluate the outcomes, patterns of failure, and current treatments. Methods: We identified 5 patients presenting with synovial sarcoma of the head and neck and treated at the University of North Carolina between 1996 and 2013. We compared our results to the literature from 1986 to 2014. Results: The study included 5 patients ranging in age from 17 to 46 (average age of 33 years). Tumor locations included the oropharynx (2 patients), and rarely reported sites of the submandibular gland, medial canthus, and mandible. Mean follow-up was 62.6 months. The recurrence rate was 40% with 2-year and 5-year disease-free survival rates of 100% and 33.3%, respectively. Prognostic factors included large tumor size (greater than 5cm), grade, surgical margin status, and the addition of radiotherapy. Conclusions: Our series confirms the aggressive nature and poor prognosis associated with synovial sarcoma of the head and neck. A combined-modality approach with long-term follow-up is a necessity. Journal of Nature and Science, 1(4):e68, 2015