Synovial sarcoma of the larynx in a 79-year-old woman, confirmed by karyotyping and fluorescence in situ hybridization analysis

BACKGROUND: Synovial sarcoma is an uncommon tumor of the head and neck and is an exceedingly rare finding in the larynx. Generally, it afflicts younger patients and most often occurs in the hypopharynx. METHODS AND RESULTS: We report a case of a biphasic synovial sarcoma arising in the arytenoid fold of a 79-year-old woman. The diagnosis was confirmed by an extensive immunohistochemical panel, karyotyping, and fluorescence in situ hybridization (FISH). The patient was treated with total laryngectomy, and she did well postoperatively. CONCLUSION: To our knowledge, our patient is the oldest ever to be reported in the literature, concluding that although this entity is considered a disease of young patients, it still has to be included in the differential diagnosis in older patients. Second, our report is only the third to describe t(X;18) (p11.2;q11.2) by karyotyping and the first ever by using FISH analysis, thus adding more cytogenetic data to the literature in this rare location and confirming the use of FISH in making the accurate diagnosis.