Synovial sarcoma of cervicodorsal spine: A case report

Synovial sarcoma is a soft-tissue sarcoma. Its involvement of the spine is extremely rare. We report a 40 year old male who presented with shoulder pain and progressive weakness in all four limbs for six months with a visible, slowly growing bulge in his upper back. On examination he had quadriparesis and diffuse sensory deficit. MRI of the cervical spine showed a large soft tissue mass, iso to hypointense, extending into the neural canal, compressing the cord. The mass had a few internal areas of contrast enhancement with extension into the right paraspinal regions involving the vertebral bodies. Sub-periosteal spine dissection was done. Tumour was primarily extradural, involving and extending from paraspinal soft tissues to the posterior arches, laminae and spinous processes of the verteberae, with their destruction. Gross radical removal of the visible mass was done, followed by three cycles of radiation therapy. Excisional biopsy showed synovial sarcoma TYPE II. In conclusion, synovial sarcomas should be kept in the differentials of a mass arising in spinal axis.