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Pharyngeal synovial sarcoma

Case contributed by Nirav Das
Diagnosis certain

Presentation

Presenting with hemoptysis and dyspnea with a two week history of dysphagia.

Patient Data

Age: 15 years
Gender: Male
x-ray

6 cm mass well defined lobulated mass in the posterior pharynx, narrowing the airway.

mri

The lesion demonstrates T1 isointense, T2 hyperintense signal with strong homogeneous enhancement. The mass is more anteriorly oriented than on the radiograph, with a discrete margin between the lesion and the base of tongue.

Bilateral enhancing cervical lymph nodes.

Case Discussion

This case demonstrates a less common site (approximately 5%) of synovial cell sarcoma.

Pathology from tumor excision returned synovial sarcoma, monophasic spindle cell. Tumors can be biphasic (containing spindle cell and epithelial components), monophasic, or poorly differentiated.

The operative report stated the attachment site was along the lateral pharyngeal wall, which was not identifiable on imaging due to the size.

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