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喉滑膜肉瘤,一种罕见且不常见的疾病。病例报告。

Synovial sarcoma of the larynx, a rare and unusual entity. Case report.

作者信息

Martín Pérez Jesús Antonio, Gurrola Machuca Héctor, Núñez Guardado Gabriela, Navarrete Tolentino Juan Carlos, Acosta Cortés Diego Armando, Martínez Mijares Carolina

机构信息

Surgical Oncology Department, National Medical Center "20 de Noviembre", Mexico City, MX, Mexico.

Surgical Oncology Department, National Medical Center "20 de Noviembre", Mexico City, MX, Mexico.

出版信息

Int J Surg Case Rep. 2025 Jan;126:110716. doi: 10.1016/j.ijscr.2024.110716. Epub 2024 Dec 9.

Abstract

INTRODUCTION AND IMPORTANCE

Synovial sarcoma (SS) is a high-grade malignancy, accounting for 2.5-3.5 % of all primary H&N sarcomas and 0.1 % of all H&N cancers.

CASE PRESENTATION

A 26-year-old woman presents with dyspnea and dysphonia. Flexible nasofibrolaryngoscopy and CT were performed with evidence of a laryngeal tumor. Total laryngectomy was performed due to a histopathological report of laryngeal synovial sarcoma.

CLINICAL DISCUSSION

Primary SS of the H&N is rare and accounts for <5 % of all synovial sarcomas and laryngeal-origin SS represents a rare subset within H&N sarcomas. There are 3 different histologic subtypes: biphasic, monophasic and poorly differentiated. Immunohistochemistry plays a crucial role in histologic diagnosis. The optimal treatment of synovial sarcoma is multimodal, depending on its size, location and grade. Radical surgical excision with negative margins is generally accepted as the mainstay of treatment. Disease recurrence is a significant problem, with up to 45 % of patients developing local disease and 33 % developing metastatic disease.

CONCLUSIONS

Laryngeal SS is exceptionally rare, requiring complex, multidisciplinary management.

摘要

引言与重要性

滑膜肉瘤(SS)是一种高级别恶性肿瘤,占所有原发性头颈部肉瘤的2.5 - 3.5%,占所有头颈部癌症的0.1%。

病例介绍

一名26岁女性出现呼吸困难和声音嘶哑。进行了纤维鼻咽喉镜检查和CT,发现有喉部肿瘤。由于喉部滑膜肉瘤的组织病理学报告,实施了全喉切除术。

临床讨论

头颈部原发性滑膜肉瘤罕见,占所有滑膜肉瘤的比例不到5%,而喉部起源的滑膜肉瘤是头颈部肉瘤中的罕见亚型。有三种不同的组织学亚型:双相型、单相型和低分化型。免疫组织化学在组织学诊断中起关键作用。滑膜肉瘤的最佳治疗是多模式的,取决于其大小、位置和分级。切缘阴性的根治性手术切除通常被认为是主要治疗方法。疾病复发是一个重大问题,高达45%的患者出现局部疾病,33%的患者出现转移性疾病。

结论

喉部滑膜肉瘤极为罕见,需要复杂的多学科管理。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/81fd/11697400/d9d38a1e6b50/gr1.jpg

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