Synovial Sarcoma of the Hyoid Bone Treated With Trimodality Therapy

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.