Synovial sarcoma involving the head: Analysis of 36 cases with predilection to the parotid and temporal regions

Wael Al-Daraji, Jerzy Lasota, Robert Foss, Markku Miettinen

Research output: Contribution to journalArticle

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 85y). 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 7.0cm (median: 3.5cm) and mitotic activity varied from 5cm 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.

Original languageEnglish (US)
Pages (from-to)1494-1503
Number of pages10
JournalAmerican Journal of Surgical Pathology
Volume33
Issue number10
DOIs
StatePublished - Oct 2009
Externally publishedYes

Fingerprint

Parotid Region
Synovial Sarcoma
Temporal Lobe
Head
Neoplasms
Parotid Gland
Mastoid
Ewing's Sarcoma
Cheek
Fascia
Scalp
Rectum
Esophagus
Mouth
Melanoma
Skeletal Muscle
Neck
Radiation
Breast Neoplasms
Bone and Bones

Keywords

  • Biological behavior
  • Fluorescence in situ hybridization
  • Head
  • Parotid region
  • Prognostic factors
  • Sarcoma
  • Synovial sarcoma
  • Temporal region
  • Temporomandibular

ASJC Scopus subject areas

  • Anatomy
  • Pathology and Forensic Medicine
  • Surgery

Cite this

Synovial sarcoma involving the head : Analysis of 36 cases with predilection to the parotid and temporal regions. / Al-Daraji, Wael; Lasota, Jerzy; Foss, Robert; Miettinen, Markku.

In: American Journal of Surgical Pathology, Vol. 33, No. 10, 10.2009, p. 1494-1503.

Research output: Contribution to journalArticle

Al-Daraji, Wael ; Lasota, Jerzy ; Foss, Robert ; Miettinen, Markku. / Synovial sarcoma involving the head : Analysis of 36 cases with predilection to the parotid and temporal regions. In: American Journal of Surgical Pathology. 2009 ; Vol. 33, No. 10. pp. 1494-1503.
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