RESUMO
Synovial sarcoma (SS) is a malignant soft tissue tumor that usually arises in the para-articular regions of the extremities. Only nine cases of SS in the mandible have been reported to date. The present study described a case of SS arising from the left mandible. A 54-year-old woman was referred to Kyushu University Hospital (Fukuoka, Japan) with a complaint of numbness in the left mental nerve area. Computed tomography revealed replacement of the left mandibular bone marrow with soft tissue and destruction of the mandibular canal. Magnetic resonance imaging revealed an isointense mass on T1-weighted images and hyperintensity on T2-weighted images. The tumor showed homogeneous enhancement. A biopsy was performed, and monophasic SS was diagnosed based on immunohistochemical staining features and genetic analysis. Hemimandible dissection and supraomophyoid neck resection were performed with fibular osteocutaneous flap reconstruction, followed by adjuvant chemotherapy. There was no evidence of recurrence or distant metastases. The present study also reviewed the clinical, imaging, histological, and immunohistochemical features of the SS in the mandible.
RESUMO
Marsupialisation, by which a surgical window is created in the cavity of a cystic lesion, has been recommended to avoid the formation of a bony defect in the jaw and a reduction in a patient's quality of life. However, information about the factors that affect the reduction in the size of a cyst after marsupialisation is limited. We have studied the effects of the patient's age and the size of the primary lesion on the speed of shrinkage after marsupialisation of keratocystic odontogenic tumours (KCOTs), dentigerous cysts, and radicular cysts. The speed of shrinkage (mm(2)/month) was evaluated by measuring the radiolucent area on panoramic radiographs taken before and after marsupialisation for KCOT (n=28), dentigerous cysts (n=26), and radicular cysts (n=18) in the mandibular molar regions. The mean duration of marsupialisation for each type of cyst was 11 (5), 8 (5), and 5 (2) months, respectively. The radiolucent area decreased linearly in the 3 types depending on the time after marsupialisation: r=-0.86 (p<0.01), r=-0.73 (p<0.01), and r=-0.72 (p<0.01), respectively. The relative speed of shrinkage did not correlate with the age of the patients, though it did correlate with the size of the radiolucent area before marsupialisation in KCOT (r=0.69, p<0.01) and radicular cysts (r=0.73, p<0.01). These results suggest that the size of a cyst before marsupialisation may affect the speed of shrinkage in KCOT and radicular cysts, while the age of the patient does not.
