A rare case of synovial sarcoma affecting paraspinal muscles in the cervical region

Abstract

Introduction: Synovial sarcoma is a rare tumor, and the spine is its infrequent site of occurrence. Past studies which depict challenges during surgery and survival in patients treated with synovial sarcoma of the spinal region are limited. Case report: We present a 13-year-old male, with a lump over the posterior aspect of the neck on the right side. MRI & USG guided biopsy revealed synovial sarcoma affecting paraspinal muscles of the right side with bony erosions over the spinous process of cervical vertebrae. PET scan results confirmed paraspinal muscles as the primary site of the tumor with no evidence of distant metastasis. The patient underwent marginal excision followed by radiotherapy. The patient was regularly followed up for 2.5 years. Discussion: Wide excision of synovial sarcoma affecting the spine is a challenging task with the risk of tumor spillage, especially with cystic components. We used low-strength cautery and gentle dissection to avoid rupture of the cyst wall. The patient is disease-free during his 2.5 years of follow-up. However, we are awaiting a long-term follow-up to assure whether the patient remains disease-free or not.

Keywords

• Synovial sarcoma
• Wide excision
• Paraspinal muscles
• Case report
• Cervical spine