喉頭に生じた滑膜肉腫例

抄録

Synovial sarcoma is a malignant tumor that is said to account for about 10% of all malignant soft tissue tumors. It occurs predominantly in young adults and most frequently arises from the joints of the extremities; it is relatively rare in the head and neck region.

We report a case of synovial sarcoma of the larynx in an elderly woman. The patient was a 77-year-old woman who visited a previous hospital with a 2-month history of sore throat and cough, and examination revealed a neoplastic lesion extending from the left vocal cord to the false vocal cord. On biopsy, the lesion was suspected as being a synovial sarcoma or sarcomatoid carcinoma, and the patient was referred to our department for further examination and treatment.

Since the patient had airway obstruction, a tracheotomy was performed under general anesthesia on the day after the initial examination. In addition, tumor biopsy was performed again for a definitive diagnosis and a specimen was also submitted for genetic testing. The genetic testing revealed SS18-SSX2 mRNA, which led to the definite diagnosis of synovial sarcoma. Total laryngectomy with left neck dissection was performed as curative treatment. Permanent histopathology of the resected specimen showed curative resection and no lymph node metastasis. Since the effectiveness of radiotherapy and chemotherapy for synovial sarcoma has not yet been established, no postoperative treatment was planned. Synovial sarcoma is generally considered as carrying a poor prognosis, and careful follow-up of the patient is required.