Iftikhar Haissan, Akhtar Shabbir, Uddin Nasir
Department of Otolaryngology, Aga Khan University hospital, Karachi, Pakistan.
Department of Pathology, Aga Khan University hospital, Karachi, Pakistan.
Iran J Otorhinolaryngol. 2019 Jan;31(102):69-72.
Synovial sarcoma makes up 8-10% of all soft tissue sarcomas, and constitutes 3-10% of all sarcomas occurring in the head and neck region. It shows male predominance (3:2), and the mean age of presentation is 30 years.
A 51-year-old gentleman presented with right-sided neck swelling which had been progressively increasing in size for the past 2 years. A computed tomography (CT) scan revealed a large heterogeneously enhancing mass on the right side of the neck measuring 7.5 × 6.2 cm. Biopsy of an enlarged node revealed papillary thyroid carcinoma. The patient subsequently underwent total thyroidectomy with right neck dissection. Final histopathology revealed a papillary carcinoma of the thyroid, and the right-sided mass was shown to be monophasic synovial sarcoma.
We present a case of a concurrent pathology of neck papillary thyroid carcinoma with monophasic synovial sarcoma. We experienced difficulty in diagnosis and misdirection due to raised C-reactive protein (CRP) levels, until final histopathology of the neck mass.
滑膜肉瘤占所有软组织肉瘤的8 - 10%，在头颈部发生的所有肉瘤中占3 - 10%。该病男性居多（比例为3:2），平均发病年龄为30岁。
一名51岁男性患者，右侧颈部肿胀，在过去2年中逐渐增大。计算机断层扫描（CT）显示右侧颈部有一个7.5×6.2厘米的大肿块，增强扫描呈不均匀强化。对一个肿大淋巴结进行活检，结果显示为甲状腺乳头状癌。患者随后接受了全甲状腺切除术及右侧颈部清扫术。最终组织病理学检查显示为甲状腺乳头状癌，右侧肿块为单相滑膜肉瘤。
我们报告了一例颈部甲状腺乳头状癌与单相滑膜肉瘤并存的病例。在颈部肿块的最终组织病理学检查之前，由于C反应蛋白（CRP）水平升高，我们在诊断上遇到困难并出现了误诊。
