[Synovial cell sarcomas of the head- and neck area]

The synovial cell sarcoma is a malignant soft tissue tumour which mostly occurs associated with or in a large joint. To date, the histogenetic origin has been discussed controversially and there is still no agreement as to whether it arises from normal synovium of joints, tendon sheaths or bursae, specialised forms of mesenchymal tissue (arthrogenous 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 synovial 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 (radical operation, radiotherapy, chemotherapy), recurrence of the tumour occurred locally, as well as metastases in the lungs and bones. The patient died three and a half years after the initial diagnosis of the tumour. The second patient suffered multiple metastases in the lungs and bones one year after operation followed by chemotherapy. To the present time there is no general agreement on how to treat synovial cell sarcomas, but without doubt first of all radical surgical excision must be performed if possible. Additional radiation and/or multidrug chemotherapy may be useful in special cases. In our opinion every case of synovial cell sarcoma should be published because it is of importance to get to know new aspects and therapeutical possibilities of this rare disease.