Saghravanian Nasrollah, Rahpeyma Amin, Ghorbani Mahsa, Saeedi Pooya
Oral and Maxillofacial Disease Research Center, School of Dentistry Mashhad University of Medical Sciences Mashhad Iran.
School of Dentistry Mashhad University of Medical Sciences Mashhad Iran.
Clin Case Rep. 2023 Nov 25;11(11):e8254. doi: 10.1002/ccr3.8254. eCollection 2023 Nov.
Synovial sarcoma, a malignant mesenchymal tumor, is primarily associated with the extremities. Nevertheless, its appearance within the head and neck region, particularly in the maxillary area, is remarkably rare. This rarity underscores the significance of each case in unraveling the complexities of its behavior and management strategies. The core focus of this research is a detailed case report involving a 6-year-old female patient who presented with a conspicuous swelling in the left posterior maxilla. Subsequent incisional biopsy led to microscopic identification of malignant spindle cell proliferation, marked by dysplastic changes, and abundant mitoses. Immunohistochemical (IHC) analysis demonstrated negative reactivity for neural and muscular markers, while positive expression of Vimentin, Bcl-2, and TLE1. These morphological and IHC findings coalesced to definitively diagnose synovial sarcoma, substantiated by a notable 40% Ki67 proliferative index. The chosen treatment strategy encompassed surgery and radiotherapy, which yielded successful outcomes, with no recurrence observed during the one-year follow-up period. Beyond the specific case, this article undertakes a review of existing literature, meticulously analyzing nine similar cases reported in scholarly sources.
滑膜肉瘤是一种恶性间充质肿瘤,主要发生于四肢。然而,它在头颈部区域出现,尤其是在上颌区域,极为罕见。这种罕见性凸显了每一个病例对于揭示其行为复杂性和治疗策略的重要性。本研究的核心是一份详细的病例报告,涉及一名6岁女性患者,该患者左上颌后部出现明显肿胀。随后的切开活检在显微镜下发现了恶性梭形细胞增殖,其特征为发育异常改变和大量有丝分裂。免疫组织化学(IHC)分析显示神经和肌肉标志物呈阴性反应,而波形蛋白、Bcl-2和TLE1呈阳性表达。这些形态学和IHC结果共同明确诊断为滑膜肉瘤,显著的40% Ki67增殖指数证实了这一诊断。所选择的治疗策略包括手术和放疗,取得了成功的结果,在一年的随访期内未观察到复发。除了这个具体病例,本文还对现有文献进行了综述,仔细分析了学术资料中报道的9个类似病例。