Journal List > J Korean Assoc Oral Maxillofac Surg > v.37(6) > 1032519

J Korean Assoc Oral Maxillofac Surg. 2011 Dec;37(6):545-549. Korean.
Published online December 27, 2011.
Copyright © 2011 by The Korean Association of Oral and Maxillofacial Surgeons
Synovial sarcoma in the buccal space: a case report
Ji-Hoon Han,1 Kyu-Ho Yoon,1 Jeong-Kwon Cheong,1 Jung-Ho Bae,1 Hsueh-Yu Li,1 Young-Il Oh,1 Jae-Myung Shin,2 Jee-Seon Baik,2 and Kwan-Soo Park1
1Department of Oral and Maxillofacial Surgery, Sanggye Paik Hospital, Inje University College of Medicine, Seoul, Korea.
2Department of Oral and Maxillofacial Surgery, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Korea.

Corresponding author: Kwan-Soo Park. Department of Oral and Maxillofacial Surgery, Sanggye Paik Hospital, Inje University College of Medicine, 761-1 Sanggye 7 dong, Nowon-gu, Seoul 139-707, Korea. TEL: +82-2-950-1161, FAX: +82-2-950-1167, Email:
Received August 11, 2011; Revised October 11, 2011; Accepted November 23, 2011.


Synovial sarcoma (SS) is a malignant soft tissue tumor comprising 5-10% of all soft tissue sarcomas. This tumor normally occurs in the paraarticular regions of the extremities but is rare in head and neck sites. SS is sometimes difficult to diagnose because it can mimic benign lesions both clinically and radiologically. This paper presents a rare case of a SS of the buccal space of a 25-year old man. The histology examination and immunohistochemistry of the mass led to a diagnosis of synovial sarcoma. The patient was treated primarily with a surgical resection, followed by radiotherapy and chemotherapy. The follow up examination 17-months after surgery showed no signs of tumor relapse or metastasis.

Keywords: Synovial sarcoma; Head and neck neoplasms


Fig. 1
Pre-operative extraoral photo.
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Fig. 2
Pre-operative intraoral photo. Palpable elevated mass on right buccal mucosa and retromolar area.
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Fig. 3
Pre-operative computed tomography. Round shaped relatively well-defined mild to moderately enhancing inhomogeneous mass (3.2 cm×2.8 cm, arrow) with internal high density foci in right buccal space without adjacent bony erosions.
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Fig. 4
Pre-operative salivary gland sonography. Ovoid shaped well-defined heterogeneous mass (2.8 cm×2.5 cm×3.9 cm) with increased blood flow in right buccal space.
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Fig. 5
Gross finding. Well defined pinkish gray soft tissue (5 cm×4 cm×3 cm).
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Fig. 6
Photomicrographs of synovial sarcoma in the buccal space. A. It reveals proliferation of spindle cells and the epithelial components forming gland-like structures (H&E staining, ×200). B. The spindle cells are stained for bcl-2 immunoreactivity (×200). C. The spindle cells are stained for CD99 immunoreactivity (×200). D. The epithelial components are stained for cytokeratin immunoreactivity (×200).
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Fig. 7
Post-operative intraoral photo (15-months after). Scar formation on right retromolar area.
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Fig. 8
Post-operative computed tomography (15-months after). Mild fat infiltration and fascial thickening in right retromolar and buccal space.
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