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Primary soft palate biphasic synovial sarcoma - case report and literature review

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BACKGROUND. Synovial sarcomas of the soft tissue are a particular type of sarcomas that rarely appear in the head and neck region.

CASE REPORT AND COMMENTS. We present the case of a 27-year-old patient diagnosed in 2017 with soft palate biphasic synovial sarcoma who presented with recurrent microepistaxis, nasal obstruction, left cephalalgia and aural fullness in the left ear. The clinical examination showed a tumor with approximately 4/6 cm in diameter, covered with sero-sanguinolent secretions, pulsating in nature, completely obstructing the left choana. The surgical treatment consisted of complete removal of the tumor under endoscopic guidance with electrocauterization of the insertion area, without further postoperative radiotherapy. The histopathological aspect was suggestive for pleomorphic sarcoma, poorly differentiated, confirming the local recurrence of the tumor. The patient also presented lung metastasis from undifferentiated malignant tumor.

CONCLUSION. The particularity of this case is represented by the extremely rare occurrence of synovial sarcoma in the head and neck region, especially at the level of the soft palate. Complete resection of the tumor with negative margins represent the mainstay of treatment, associated with adjuvant radiotherapy, with an important role in improving disease-specific survival.