Clin Exp Otorhinolaryngol.  2011 Dec;4(4):204-206.

Synovial Sarcoma of the Thyroid Gland

• Ryu CH
• Cho KJ
• Choi SH

Abstract

Primary synovial sarcoma of the thyroid is an extremely rare condition which has only been reported twice in the literature. We herein report a case of highly aggressive and rapidly lethal primary synovial sarcoma of the thyroid. A 72-year-old woman presented with extensive local invasion, rapid progression, and early distant metastasis secondary to primary thyroid synovial sarcoma. The tumor exhibited an atypical histologic and immunohistochemical staining pattern. Detection of SYT/SSX fusion transcript confirmed the diagnosis of synovial sarcoma. Due to the aggressive nature of primary synovial sarcoma of the thyroid gland, early diagnosis and comprehensive treatment including wide resection and postoperative chemoradiation is required.

Keyword

Synovial sarcoma; Thyroid gland

MeSH Terms

Aged
Early Diagnosis
Female
Humans
Neoplasm Metastasis
Sarcoma, Synovial
Thyroid Gland

Figure

• 

  Fig. 1 Preoperative radiologic findings. (A) Axial computed tomography (CT) scan showed a large low attenuation mass replacing the thyroid gland with possible invasion to the trachea. (B) Axial CT scan performed 2 weeks after the first CT scan revealed tracheal intraluminal invasion. (C) Chest CT scan showed multiple variable sized nodular lesions suggestive of lung metastasis.

• 

  Fig. 2 Gross and microscopic findings of the surgical specimen. (A) The main mass measured 6×5×4.5 cm. The cut surface of the tumor was yellow and lobulated with fibrous septa and myxoid change. (B, C) The tumor was consisted of fascicles and sheets of dense, uniform, relatively small ovoid neoplastic cells that showed a hemangiopericytic vascular pattern. Epithelial component was not identified (B: H&E, ×100; C: H&E, ×200).

Reference

1. Dei Tos AP, Dal Cin P, Sciot R, Furlanetto A, Da Mosto MC, Giannini C, et al. Synovial sarcoma of the larynx and hypopharynx. Ann Otol Rhinol Laryngol. 1998; 12. 107(12):1080–1085. PMID: 9865642.

2. Kikuchi I, Anbo J, Nakamura S, Sugai T, Sasou S, Yamamoto M, et al. Synovial sarcoma of the thyroid: report of a case with aspiration cytology findings and gene analysis. Acta Cytol. 2003; May-Jun. 47(3):495–500. PMID: 12789939.

3. Jang KS, Min KW, Jang SH, Paik SS, Tae K, Jang SJ, et al. Primary synovial sarcoma of the thyroid gland. J Korean Med Sci. 2007; 9. 22(Suppl):S154–S158. PMID: 17923744.

4. Chan JA, McMenamin ME, Fletcher CD. Synovial sarcoma in older patients: clinicopathological analysis of 32 cases with emphasis on unusual histological features. Histopathology. 2003; 7. 43(1):72–83. PMID: 12823715.

5. Fisher C, de Brujin DR, van Kessel AG. Fletcher CD, Unni KK, Mertens F, editors. Synovial sarcoma. Pathology and genetics of tumors of soft tissue and bone. 2002. Lyon: IARC Press;p. 200–204.

6. Lee GH, Lee BC, Kwon YJ, Jung YW. Two cases of synovial sarcoma arising in the anterior neck. Korean J Otolaryngol-Head Neck Surg. 2006; 9. 49(9):952–955.

7. Alberty J, Dockhorn-Dworniczak B. Monophasic synovial sarcoma of the neck in an 8-year-old girl resembling a thyroglossal duct cyst. Int J Pediatr Otorhinolaryngol. 2002; 3. 15. 63(1):61–65. PMID: 11879931.

8. Coindre JM, Pelmus M, Hostein I, Lussan C, Bui BN, Guillou L. Should molecular testing be required for diagnosing synovial sarcoma? A prospective study of 204 cases. Cancer. 2003; 12. 15. 98(12):2700–2707. PMID: 14669292.