Monophasic epithelial synovial sarcoma arising in the temporomandibular joint.

Division of Dentistry and Oral-Maxillofacial Surgery, Chiba University Hospital, 1-8-1 Inohana, Chiba 260-8677, Japan.
International Journal of Oral and Maxillofacial Surgery (Impact Factor: 1.52). 09/2007; 36(8):762-5. DOI: 10.1016/j.ijom.2007.02.014
Source: PubMed

ABSTRACT Synovial sarcoma is a mesenchymal spindle-cell tumour that occurs infrequently in the head and neck. It originates from unknown stem cells differentiating into mesenchymal and/or epithelial structures. Most synovial sarcomas are biphasic in character, consisting of epithelial and spindle-cell elements. Here is reported a case of monophasic epithelial synovial sarcoma arising in the temporomandibular joint. The tumour was of a predominantly epithelial pattern, although a minute area of sarcomatous cells was found. The primary mode of treatment was wide en-bloc excision. Two years after surgery, the patient died of hepatocellular carcinoma, but there was no evidence of synovial sarcoma recurrence.

  • [Show abstract] [Hide abstract]
    ABSTRACT: Synovial sarcoma is a mesenchymal spindle cell tumor with variable epithelial differentiation. It is unrelated to the synovium as the name might suggest but arises in the soft tissues of the extremities around the knee joints and tendon sheaths. The tumor cells are thought to resemble normal synovial tissue histopathologically, hence named "synovial sarcoma" (SS). Head and neck lesions are less common and oral cavity involvement is extremely rare. Few cases in tongue, soft palate, mandible, buccal mucosa and floor of mouth have been described in the literature. Here, we probably report the first case of primary biphasic SS (BSS) involving gingiva in the retromolar area of the mandible in a 21-year-old male patient.
    Journal of oral and maxillofacial pathology : JOMFP. 01/2014; 18(1):77-80.
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Parotid gland tumours are very heterogeneous, being benign in 80% of cases, and generally arising from epithelial cells. Nevertheless, a small group of non-epithelial tumours representing just 5% of all salivary gland neoplasms has also been reported, the most common of these being haemangioma, especially in children. However, lymphomas, neuromas, neurofibromas, lipomas and sarcomas can also be found. Synovial cell sarcoma is a high grade histological variety of sarcoma and is generally located near large joints and bursae of the lower extremities, such as knee, tendon sheaths and bursal structures. It is rarely found in the head and neck region due to its lack of synovioblastic tissue. Herewith, the case of a young female, affected by a synovial sarcoma of the left parotid gland, is presented and a review is made of the literature on this rare specific localization focusing on management and outcome.
    Acta otorhinolaryngologica Italica: organo ufficiale della SocietĂ  italiana di otorinolaringologia e chirurgia cervico-facciale 02/2011; 31(1):43-6. · 0.79 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Synovial sarcoma involving the head is rare, and data on the clinicopathologic characteristics of such tumors are scant. In this study, we examined 36 synovial sarcomas of the head excluding tumors in the oral cavity, sinonasal tract, submandibular area, neck, and intracranial space. There were 19 men and 17 women with a mean age of 35 years (range: 4 to 85 y). There was a marked predilection for the parotid (n=14) and temporal regions (n=9), and cheek (n=4). Other locations included mastoid area (n=2), infratemporal fossa (n=2), and one each from the supra-auricular scalp, maxillary, submaxillary, mandibular, and nasolabial regions. Histologically, 25 examples were of monophasic type, 10 were biphasic. Five of these cases contained a poorly differentiated Ewing sarcoma-like component and 1 was purely poorly differentiated. Histologically, 9 tumors involved skeletal muscle, 4 parotid gland (focally or in the interlobular septa), and 1 intertrabecular spaces of bone; the others involved subcutis or fascia and rarely skin. The tumor size ranged from 0.6 to 7.0 cm (median: 3.5 cm) and mitotic activity varied from <1 to 85 per 10 high-power fields (HPFs) (median, 6/10 HPFs). Keratin-positive tumor cells were detected in 19 of 19 monophasic and 1 of 1 of poorly differentiated tumors that were examined. SS18 gene rearrangement was confirmed in all 14 cases examined (3 biphasic and 11 monophasic tumors). Follow-up on 29 patients revealed that 11 were alive without disease from 2 to 31 years (median, 14 y). Ten patients died of disease 1 to 18 years after the diagnosis (median, 3 y); most of these patients had a tumor >5 cm and 6 of 10 had mitotic counts >10/10 HPFs. One patient died of an unrelated cause (metastatic melanoma) and 7 died of unknown causes. Four other patients had subsequent malignancies, including carcinomas of the breast, esophagus, rectum, and parotid gland. The latter was possibly radiation-induced, diagnosed 30 years after the synovial sarcoma. Synovial sarcoma of the head has a striking predilection for the parotid and temporal regions and the prognosis varies with many patients having long tumor-free survivals.
    The American journal of surgical pathology 08/2009; 33(10):1494-503. · 4.06 Impact Factor