Synovial Sarcoma of the Floor of the Mouth: A Rare Clinical Entity with Review of Literature

Background: Head and neck synovial sarcoma (SS) amounts to 6.8% of all total body SS, with high incidences in the hypo­ pharynx, postpharyngeal region and the parapharyngeal space. Also, incidences of SS in the tongue, soft palate, mandible, buccal mucosa, floor of the mouth, lungs, thymus, trunk and posterior peritoneum are reported. Case report: We report a case of 12­ year ­ old girl with swelling in the floor of the mouth for 2 months. The patient had difficulty in speech, tongue movements, poor oral hygiene due to food residue collecting around the tumor in the floor of the mouth. A smooth 4 × 4 cm globular ma ss arising from the floor of the mouth with the fine needle aspiration cytology (FNAC) as spindle cell neoplasm. Wide excision and immunohistology confirmed it as calcified synovial sarco ma, hence postoperative chemo ­ therapy was given. There is no recurrence for the past 3 years. Conclusion: Synovial sarcoma is a rare tumor in the oral cavity, which is slow growing and of variable aggressiveness. Immunohistological analysis confirming the diagnosis and wide surgical excision with adjuvant chemotherapy is the modality preferred in these cases. Recurrence is common in the first 2 years of therapy but can occur later also.