A Rare Case of Primary Spindle Cell Synovial Sarcoma of Scalp

Abstract

Abstract Synovial sarcoma is a variant of soft-tissue sarcoma, but has a very aggressive course. It is very rare overall, constituting only 5%–10% of all soft-tissue sarcomas. Head and neck constitutes 3%–5% of cases. It is more common in males in the 15–40 years age group. Hence, histopathological confirmation is required for diagnosis along with radiological investigations like magnetic resonance imaging. If histopathology/immunohistochemistry also cannot give a definitive diagnosis, chromosomal translocation t(x; 18) (p11.2–q11.2) assay is required as it is present in more than 90% of cases. Rarity of cases leads to the absence of proper treatment guidelines. Here, we are reporting a case of a large primary spindle cell synovial sarcoma of the scalp in a 57-year-old female, developed just over a month, pushing brain parenchyma, describing her treatment by volumetric modulated arc therapy (VMAT) radiotherapy to spare surrounding critical organs, particularly brain and eyes.