Synovial Sarcoma of the Hyoid Bone Treated With Trimodality Therapy.
This report describes a 62-year-old man with translocation-positive synovial sarcoma of the hyoid bone who achieved a pathologic complete response and remained disease-free for 5 years after anthracycline/ifosfamide-based neoadjuvant chemotherapy, surgery, and adjuvant radiation.
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This report describes a 62-year-old man with translocation-positive synovial sarcoma of the hyoid bone who achieved a pathologic complete response and remained disease-free for 5 years after anthracycline/ifosfamide-based neoadjuvant chemotherapy, surgery, and adjuvant radiation.
Research significance
The case provides evidence that trimodality therapy can produce a durable complete response in an individual patient with hyoid-bone synovial sarcoma; it only suggests, rather than establishes, that neoadjuvant chemotherapy may improve resectability or outcomes in similarly rare head-and-neck disease, including adolescent or young-adult cases.
Source abstract
Synovial sarcoma (SS) is a rare, high-grade mesenchymal malignancy accounting for 5% to 10% of all soft tissue sarcomas, most commonly arising in the extremities of adolescents (ages 13-17) and young adults (ages 18-24). Head and neck involvement is uncommon, representing approximately 5% of cases, with primary involvement of the hyoid bone being exceedingly rare. To date, only 2 cases of SS of the hyoid bone have been reported in the literature. The authors have presented the third reported case of SS originating from the hyoid bone, successfully treated with a trimodality approach. A 62-year-old of male sex presented with a left-sided neck mass and was diagnosed with translocation (X;18) (p11.2; q11.2)-positive SS. The patient underwent neoadjuvant chemotherapy with an anthracycline- and ifosfamide-based regimen, followed by surgical resection and adjuvant radiation therapy, achieving a pathologic complete response. The patient remains disease-free 5 years following treatment. This case highlighted the importance of multidisciplinary management and supported the potential role of neoadjuvant chemotherapy in optimizing outcomes for rare head and neck SS.