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Introduction <p>The clinical paper presents an exceptionally rare and first case of primary intraosseous synovial sarcoma of symphysis region of mandible in a 36-year-old female.</p> Observation <p>Patient presented with 2-month history of pain and swelling in chin region. Clinical and radiographic picture raised suspicion of malignancy. Histopathological and immunohistochemistry with TLE-1 positive confirmed the final diagnosis of primary intraosseous synovial sarcoma of monophasic histology.</p> Management <p>A thorough diagnostic work-up remains crucial for accurate diagnosis and effective management. Wide local composite resection of lesion with preservation of lower lip and bilateral selective neck dissection level I-IV followed by reconstruction with double flap technique to restore function and aesthetics. Plantaris tendon was incorporated as a structural scaffold for lower lip.</p> Conclusion <p>Surgical intervention resulted in a favourable postoperative outcome, with no recurrence, metastasis, or flap failure observed at 21&#xa0;months with satisfactory functional rehabilitation. Adjuvant radiotherapy and chemotherapy remain as standby options due to the high risk of late local recurrence and pulmonary metastasis associated with SS. Long-term follow-up is recommended, considering the aggressive nature of SS in the head-and-neck region.</p>

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Synovial Sarcoma of Symphysis of Mandible

  • 期刊论文

  • 发表日期：

    2025年6月28日

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  • Hari Ram,
  • S. Hemanth Kumar,
  • Deepika Kumari Jain,
  • Krishna Vasaiya

摘要

Introduction

The clinical paper presents an exceptionally rare and first case of primary intraosseous synovial sarcoma of symphysis region of mandible in a 36-year-old female.

Observation

Patient presented with 2-month history of pain and swelling in chin region. Clinical and radiographic picture raised suspicion of malignancy. Histopathological and immunohistochemistry with TLE-1 positive confirmed the final diagnosis of primary intraosseous synovial sarcoma of monophasic histology.

Management

A thorough diagnostic work-up remains crucial for accurate diagnosis and effective management. Wide local composite resection of lesion with preservation of lower lip and bilateral selective neck dissection level I-IV followed by reconstruction with double flap technique to restore function and aesthetics. Plantaris tendon was incorporated as a structural scaffold for lower lip.

Conclusion

Surgical intervention resulted in a favourable postoperative outcome, with no recurrence, metastasis, or flap failure observed at 21 months with satisfactory functional rehabilitation. Adjuvant radiotherapy and chemotherapy remain as standby options due to the high risk of late local recurrence and pulmonary metastasis associated with SS. Long-term follow-up is recommended, considering the aggressive nature of SS in the head-and-neck region.