Synovial Sarcoma of the Head and Neck: A Case of Predominantly Cystic Mass
Ji Kang Parka,
Soo Youn Hama,
Jae Cheol Hwanga,
Yoong Ki Jeonga,
Jong Hwa Leea,
Seoung-Oh Yanga,
Jae-Hee Suhb and
Dae Hwa Choic
a Department of Radiology, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea
b Department of Pathology, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea
c Department of Surgery, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea
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FIG 1. Sonograms.
A, Gray-scale sonogram shows a well-defined 1.6 x 2-cm mass with posterior acoustic enhancement. An echogenic central septum (white arrow) and slightly low echoic peripheral thick wall (white arrowheads) are seen.
B, Color Doppler sonogram shows increased vascularity at the septal solid portion of the lesion (white arrows).
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FIG 2. CT scans.
A, Noncontrast axial CT scan shows a well-defined submental mass with central, low attenuation. A solid mural component is present. CT attenuation number of central portion is 20.2 H. There is no remarkable fat infiltration adjacent to the mass.
B, Contrast-enhanced axial CT scan shows moderately enhanced peripheral wall and nodular mural components (white arrowheads). Mass abuts partly to the hyoid bone, at its medial aspect.
C, Contrast-enhanced coronal CT scan shows a thick central solid septa (white arrowhead). The hyoid bone (white arrow) is located next to the medial aspect of the lesion. The boundary between the upper part of the mass and mouth floor is indistinct.
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FIG 3. Pathologic findings.
A, Microphotograph of the solid portion shows classic biphasic synovial sarcoma with glandular structures surrounded by a spindle cell component. The glandular structures have intraluminal eosinophilic secretions (Hematoxylin and eosin, x200).
B, Immunohistochemistry for cytokeratin highlights the epithelial elements. The spindle cell elements reveal focal cytokeratin immunoreactivity (cytokeratin [AE1/AE3], ABC method, x200).
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