Primary Thyroid Synovial Sarcoma: Case Report of a Rare Tumor and a Brief Review of the Literature

Abstract

Synovial Sarcoma (SS) is a high-grade mesenchymal tumor generally appearing in the lower extremities, with only five percent of cases appearing in the head and neck region. This case report highlights the twentieth reported case of Primary Thyroid Synovial Sarcoma (PTSS) in the world literature, this one was identified in Central Africa. Our treatment plan stemmed from analyzing the previously documented cases of PTSS over the last 22 years to understand the etiology, diagnostic modalities, treatment, and post-operative management. Pre-operative Fine Needle Aspiration (FNA) diagnosed spindle cell malignancy but was insufficient to determine a specific diagnosis. A definitive diagnosis of PTSS was made based on her clinical condition after thyroidectomy with debulking surgery and lymph node dissection. We recommended post-operative treatment with radiation therapy and adjuvant chemotherapy with six cycles of doxorubicin and ifosfamide. The patient recovered uneventfully and remained recurrence-free for 38 months before she was lost to follow-up. This outcome was not typical of most of the previously reported cases. Although our patient was appropriately diagnosed and PTSS was identified, we believe further studies need to be conducted to make diagnosis and treatment easier and raise the awareness of clinicians on this rare neoplasm.