Se presenta el caso clínico de un paciente varón de 49 años, afecto de un sarcoma sinovial de la región cervical posterior.
Los sarcomas sinoviales son tumores malignos de partes blandas cuya incidencia se estima entre un 5 y un 15% del total de sarcomas. La localización cervical es infrecuente, estableciéndose entre un 3 y un 10% de los sarcomas sinoviales.
La aparición de una masa indolora en la región cervical constituye su manifestación más frecuente. Los hallazgos radiológicos son inespecíficos y no permite por lo general la identificación preoperatoria de la lesión. El diagnóstico se establece mediante biopsia de la tumoración, en base a sus características histopatológicas e inmunohistoquímicas.
La extirpación quirúrgica es el tratamiento de elección de estas neoplasias. El papel de la radioterapia y la quimioterapia en el tratamiento coadyuvante es objeto de controversia. La elevada tasa de recidiva local y de diseminación de la enfermedad, hacen frecuente en la práctica clínica el uso combinado de cirugía, radioterapia y quimioterapia en el tratamiento del sarcoma sinovial.
A case of a 49 year-old man affected by a posterior cervical synovial sarcoma is reported.
Synovial sarcomas are malignant neoplasms of soft tissue whose reported incidence ranges between 5 and 15% of sarcomas. Cervical location is uncommon, accounting for less than 10% of all synovial sarcomas.
The most frequent presenting symptom is the development of a painless mass located in the cervical region. Radiologic findings are not specific for this entity and they do not permit to identify preoperatively synovial sarcomas of the neck. Diagnosis is attained by means of lesion biopsy, after histopathological and immunohystochenmical studies are carried on tumor samples.
Surgical resection of the tumor is the treatment of choice for synovial sarcoma. The role of radiotherapy and chemotherapy in the treatment of these lesions remains under discussion. However, due to the high incidence of local recurrence of the neoplasm and its recognized trend towards metastatization, the combined use of surgery, radiotherapy and chemotherapy is common in clinical practice, after the diagnosis of this tumor has been established.
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