This report documents what appears to be the first case of synovial sarcoma arising in the orbit, highlighting the potential for diagnostic confusion with less aggressive orbital connective tissue neoplasms.
Slowly enlarging subconjunctival masses warrant synovial sarcoma consideration; first orbital case leaves open incidence and management questions.
Synovial sarcoma is one of the most common soft tissue malignancies of adolescents and young adults. Despite its name, it is no longer thought to be histogenetically derived from the synovium. What seems to be the first case of synovial sarcoma to arise in the orbit presented in a 21 year old woman as a slowly enlarging subconjunctival mass. Although this tumour was typically biphasic, the monophasic spindle cell variant arising at this site could easily be confused with less aggressive orbital connective tissue neoplasms.
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Ratnatunga et al. (1992) studied this question.
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