Synovial sarcoma is a soft tissue malignancy which most commonly affec
ts the lower limbs of young adults and rarely occurs in the head and n
eck region. The term synovial sarcoma may be a misnomer as most of the
se tumours occur in tissues not known to contain synovial tissue. Ther
e has only been one previously reported case affecting the middle ear,
which was metastatic, and we report the first case of primary synovia
l sarcoma of the middle ear.