HyperArc radiotherapy for recurrent synovial sarcoma of infratemporal fossa: a rare case report and review of the literature.

IF 0.7 Q3 MEDICINE, GENERAL & INTERNAL AME Case Reports Pub Date : 2024-08-29 eCollection Date: 2024-01-01 DOI:10.21037/acr-24-88
Wei Li, Fengjun Lou, Lijun Zhai, Meina Piao, Yinju Zhu, Shiyu Liu, Ke Li, Liang Chen, Huankun Wang
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Abstract

Background: Synovial sarcoma (SS), a malignant and uncommon soft tissue sarcoma, typically manifests in the extremities and trunk. However, its occurrence in the infratemporal fossa (ITF) of the head and neck is exceedingly rare. Patients afflicted with SS in this anatomical region pose considerable challenges, as radical surgery is often difficult to undertake, leading to a high rate of postoperative recurrence. Moreover, it is often difficult to effectively control the tumor when the cancer relapses. Much of our understanding regarding SS of ITF stems from limited case reports, with a lack of established clinical guidelines for its management. There exists a significant clinical need for effective therapeutic approaches.

Case description: This case report documents a patient with SS of ITF, experiencing repeated recurrences despite undergoing multiple surgeries and chemotherapy treatments. The patient underwent HyperArc (HA) radiotherapy (RT) in conjunction with concurrent chemotherapy utilizing cisplatin, resulting in a remarkable 3-year follow-up period devoid of recurrence.

Conclusions: The primary objective of this case report is to disseminate knowledge regarding this rare manifestation of SS of ITF, detailing the successful treatment strategy employed. In this case, we employed a comprehensive treatment strategy involving concurrent chemoradiotherapy based on HA. Our findings demonstrate that this approach was effective in achieving disease control and improving patient outcomes.

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颞下窝复发性滑膜肉瘤的超弧放射治疗:罕见病例报告和文献综述。
背景:滑膜肉瘤(SS)是一种恶性且不常见的软组织肉瘤,通常发生在四肢和躯干。然而,发生在头颈部颞下窝(ITF)的情况却极为罕见。这一解剖区域的 SS 患者面临着巨大的挑战,因为根治性手术往往难以实施,导致术后复发率很高。此外,癌症复发时往往难以有效控制肿瘤。我们对 ITF SS 的了解大多来源于有限的病例报告,缺乏成熟的临床治疗指南。临床上亟需有效的治疗方法:本病例报告记录了一名 ITF SS 患者,尽管接受了多次手术和化疗,但病情仍反复复发。该患者在接受超弧线(HA)放射治疗(RT)的同时,还接受了顺铂化疗,结果在长达 3 年的随访中没有出现复发:本病例报告的主要目的是传播有关 ITF SS 这一罕见表现的知识,详细介绍成功采用的治疗策略。在本病例中,我们采用了一种综合治疗策略,包括基于 HA 的同步化放疗。我们的研究结果表明,这种方法能够有效地控制病情并改善患者预后。
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