SYNOVIAL CELL-SARCOMA OF THE HEAD AND NEC K

The synovial cell sarcoma is a malignant soft tissue tumour which most ly occurs associated with or in a large joint. To date, the histogenet ic origin has been discussed controversially and there is still no agr eement as to whether it arises from normal synovium of joints, tendon sheaths or bursae, specialised forms of mesenchymal tissue (arthrogeno us mesenchyma) or ordinary connective tissue. The tumour rarely occurs in the head and neck region. Only about 76 cases world-wide have been described up to now We report on a case of a 30-year old man with a s ynovial cell sarcoma of the temporomandibular joint and a case of a 70 -year old man with a synovial cell sarcoma of the hypopharynx. In the first case, although all possible therapeutical efforts were made (rad ical operation, radiotherapy, chemotherapy), recurrence of the tumour occurred locally, as well as metastases in the lungs and bones. The pa tient died three and a half years after the initial diagnosis of the t umour. The second patient suffered multiple metastases in the lungs an d bones one year after operation followed by chemotherapy. To the pres ent time there is no general agreement on how to treat synovial cell s arcomas, but without doubt first of all radical surgical excision must be performed if possible. Additional radiation and/or multidrug chemo therapy may be useful in special cases. In our opinion every case of s ynovial cell sarcoma should be published because it is of importance t o get to know new aspects and therapeutical possibilities of this rare disease.