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<p>Synovial sarcoma is a rare soft tissue sarcoma that infrequently involves the head and neck region and very rarely arises from the scalp, accounting for fewer than 0.1% of cases. This manuscript reports a 51-year-old male with a 20-year history of a progressively enlarging scalp mass, notable for being the largest scalp synovial sarcoma documented to date. The tumour’s extreme vascularity necessitated preoperative angioembolization to minimize risk of haemorrhage. Surgical excision involved the en-bloc removal of the 15.4-pound mass with reconstruction by advancing scalp flaps. The patient received adjuvant radiotherapy and remained disease-free at six months follow-up. This case highlights the critical role of multidisciplinary care, emphasizing early diagnosis, comprehensive imaging, pre-operative optimization, meticulous surgical technique, and vigilant post-operative monitoring. Synovial sarcoma should be considered in differential diagnoses for primary scalp tumours despite its rarity.</p>

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Giant Primary Synovial Sarcoma of the Scalp: An Exceptionally Rare Case with Surgical and Perioperative Challenges

  • 期刊论文

  • 发表日期：

    2026年3月9日

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  • Sanjay Kumar Giri,
  • Surya Yashaswi,
  • Santanu Suba,
  • Manoj Kumar Nayak

摘要

Synovial sarcoma is a rare soft tissue sarcoma that infrequently involves the head and neck region and very rarely arises from the scalp, accounting for fewer than 0.1% of cases. This manuscript reports a 51-year-old male with a 20-year history of a progressively enlarging scalp mass, notable for being the largest scalp synovial sarcoma documented to date. The tumour’s extreme vascularity necessitated preoperative angioembolization to minimize risk of haemorrhage. Surgical excision involved the en-bloc removal of the 15.4-pound mass with reconstruction by advancing scalp flaps. The patient received adjuvant radiotherapy and remained disease-free at six months follow-up. This case highlights the critical role of multidisciplinary care, emphasizing early diagnosis, comprehensive imaging, pre-operative optimization, meticulous surgical technique, and vigilant post-operative monitoring. Synovial sarcoma should be considered in differential diagnoses for primary scalp tumours despite its rarity.