Rekürren infratemporal fossa sinovyal sarkom eksizyonu

Year 2016, Volume: 26 Issue: 5, 293 - 299, 20.10.2016

Fakih Cihat Eravcı Mehmet Düzlü Mehmet Ekrem Zorlu Metin Yılmaz Mustafa Sancar Ataç

Abstract

Sinovyal sarkom özellikle alt ekstremitelerde karşılaşılan yumuşak doku sarkomudur. İnfratemporal fossa oldukça nadir bir konumdur. Kapalı bir alan olması nedeniyle kombine yaklaşım ve multidisipliner planlama her zaman dikkate alınmalıdır. Bu olgu sıklıkla tekrarlamasına neden olan sinovyal sarkomun yüksek grade karakterini vurgulamaktadır. İnfratemporal fossada temiz cerrahi sınırın zorluğu, sinovyal sarkoma ikinci bir sıkıntılı sorun eklemektedir. Bu nedenle tamamlayıcı tedavi gereksinimi elzemdir. Bu olguda ameliyat sonrası radyoterapi uygulandı ve bir yıllık takipte lokal, bölgesel veya uzak metastaz izlenmedi. Bu yazıda, 68 yaşında bir erkek hastada mandibüler swing ve transzygomatik teknik ile total olarak eksize edilen infratemporal fossa sinovyal sarkom olgusu, önceki infratemporal fossa sinovyal sarkomların manifestasyonları, görüntüleme ve histopatolojik özellikleri ve ameliyat sonrası komplikasyon bilgileri ile birlikte sunuldu

Keywords

İnfratemporal fossa, cerrahi yaklaşım, sinovyal sarkoma

Excision of recurrent synovial sarcoma of the infratemporal fossa

Abstract

Synovial sarcoma is a soft tissue sarcoma especially encountered in the lower extremities. The infratemporal fossa is quite a rare location. Since it is a closed location, combined approaches and multidisciplinary planning always need to be considered. This case emphasizes the high-grade character of synovial sarcoma, which causes it to recur often. The difficulty of clear surgical margins in the infratemporal fossa adds to synovial sarcoma a second challenging issue. Therefore, the need of complementary therapy is essential. In this case, we applied postoperative radiotherapy and we did not observe any sign of local, regional or distant metastasis in the oneyear follow-up. In this article, we present a 68-year-old male patient together with totally excised synovial sarcoma in the infratemporal fossa by mandibular swing and transzygomatic technique information on the manifestation, imaging, histopathological features and postoperative complications of previous infratemporal fossa synovial sarcomas.

Keywords

Infratemporal fossa, surgical approache, synovial sarcoma

References

• Givi B, Liu J, Bilsky M, Mehrara B, Disa J, Pusic A, et al. Outcome of resection of infratemporal fossa tumors. Head Neck 2013;35:1567-72.
• Tiwari R, Quak J, Egeler S, Smeele L, Waal IV, Valk PV, et al. Tumors of the infratemporal fossa. Skull Base Surg 2000;10:1-9.
• Bryant L, Goodmurphy CW, Han JK. Endoscopic and three-dimensional radiographic imaging of the pterygopalatine and infratemporal fossae: improving surgical landmarks. Ann Otol Rhinol Laryngol 2014;123:111-6.
• Nomura F, Kishimoto S. Synovial sarcoma of the temporomandibular joint and infratemporal fossa. Auris Nasus Larynx 2014;41:572-5.
• Gheisari R, Roozbehi A. Malignant peripheral nerve sheath tumor of the infratemporal fossa. J Craniofac Surg 2010;21:596-8.
• Wushou A, Zhao YJ, Shao ZM. Synovial sarcoma of the infratemporal fossa: A case report. Oncol Lett 2014;8:2165-70.
• Dhawan A, Shenoy AM, Chavan P, Sandhu S, Sriprakash D. Synovial sarcoma of the infratemporal fossa with extension into the oral cavity--a rare presentation and literature review. J Oral Maxillofac Surg 2012;70:2923-9.
• Jeyanthi K, Karthikeyan R, Sherlin HJ, Anuja N, Ramani P, Priya P, et al. Pleomorphic adenoma in the infra-temporal space: the first case report. Head Neck Pathol 2007;1:173-7.
• Moreira-Gonzalez A, Pieper DR, Cambra JB, Simman R, Jackson IT. Skull base tumors: a comprehensive review of transfacial swing osteotomy approaches. Plast Reconstr Surg 2005;115:711-20.
• Maheshwari GU, Chauhan S, Kumar S, Krishnamoorthy S. Access osteotomy for infratemporal tumors: Two case reports. Ann Maxillofac Surg 2012;2:77-81.
• Chatni SS, Sharan R, Patel D, Iyer S, Tiwari RM, Kuriakose MA. Transmandibular approach for excision of maxillary sinus tumors extending to pterygopalatine and infratemporal fossae. Oral Oncol 2009;45:720-6.
• Roh JL. Removal of infratemporal fossa schwannoma via a transmandibular transpterygoid approach. Eur Arch Otorhinolaryngol 2005;262:428-31.
• Otremba M, Adam S, Omay SB, Lowlicht R, Bulsara KR, Judson B. Maxillary swing approach for extended infratemporal fossa tumors. Laryngoscope 2013;123:1607-11.
• Honda K, Asato R, Tanaka S, Endo T, Nishimura K, Ito J. Vidian nerve schwannoma with middle cranial fossa extension resected via a maxillary swing approach. Head Neck 2008;30:1389-93.
• Amin AA. Maxillary swing approach for surgical resection of recurrent nasopharyngeal tumors. J Egypt Natl Canc Inst 2007;19:219-23.
• Guo Y, Guo C. Maxillary-fronto-temporal approach for removal of recurrent malignant infratemporal fossa tumors: Anatomical and clinical study. J Craniomaxillofac Surg 2014;42:206-12.
• Timoshenko AP, Asanau A, Gavid M, Colin V, Martin C, Prades JM. Preauricular transmandibular and transzygomatic approach for tumors of the infratemporal fossa revisited. ORL J Otorhinolaryngol Relat Spec 2013;75:250-5.
• Battaglia P, Turri-Zanoni M, Dallan I, Gallo S, Sica E, Padoan G, et al. Endoscopic endonasal transpterygoid transmaxillary approach to the infratemporal and upper parapharyngeal tumors. Otolaryngol Head Neck Surg 2014;150:696-702.
• Forer B, Lin LJ, Sethi DS, Landsberg R. Endoscopic Resection of Sinonasal Tract Schwannoma: Presentation, Treatment, and Outcome in 10 Cases. Ann Otol Rhinol Laryngol 2015;124:603-8.