{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,13]],"date-time":"2025-10-13T04:43:04Z","timestamp":1760330584665,"version":"build-2065373602"},"reference-count":25,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,10,13]],"date-time":"2025-10-13T00:00:00Z","timestamp":1760313600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pediatr."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Synovial sarcoma (SS) is a malignant tumor characterized by partial epithelial differentiation. While SS predominantly affects older children and young adults, it can arise in nearly any anatomical region. Its occurrence in the tonsil, particularly in the pediatric population, is extremely rare, with only one other case reported in the literature. This rarity poses diagnostic challenges, as its symptoms often resemble more common conditions such as a peritonsillar abscess. Reporting such cases is crucial to expanding the understanding of SS, refining diagnostic approaches, and guiding treatment strategies. This case offers valuable insights into the management of SS in atypical locations.<\/jats:p><\/jats:sec><jats:sec><jats:title>Case presentation<\/jats:title><jats:p>We report the second documented case of pediatric tonsillar synovial sarcoma (SS). The patient, a 5-year-old girl, presented with a 1.5-month history of persistent fever and dysphagia. Radiological examinations revealed a mass originating from the right palatine tonsil, causing irregular narrowing of the oropharyngeal lumen, initially suspected to be a peritonsillar abscess. An incisional biopsy of the right tonsil was performed, and histopathological analysis confirmed the diagnosis of biphasic SS. The patient underwent six cycles of chemotherapy, resulting in significant tumor regression by the 6th month of treatment. This case underscores the necessity of a multidisciplinary approach, combining surgery and chemotherapy, in managing rare tumors.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>This case highlights the importance of considering rare malignancies like synovial sarcoma in the differential diagnosis of atypical tonsillar masses, especially in pediatric patients with persistent symptoms. The successful outcome achieved through a multidisciplinary approach emphasizes the need for coordinated care in managing such complex tumors. This case contributes valuable insights to the limited literature on pediatric tonsillar SS and may guide future diagnostic and therapeutic strategies for similar cases.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fped.2025.1636916","type":"journal-article","created":{"date-parts":[[2025,10,13]],"date-time":"2025-10-13T04:17:08Z","timestamp":1760329028000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Pediatric tonsillar synovial sarcoma: extremely rare case report"],"prefix":"10.3389","volume":"13","author":[{"given":"\u015eule","family":"\u00c7al\u0131\u015fkan Kam\u0131\u015f","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Beg\u00fcl","family":"Ya\u011fc\u0131","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2025,10,13]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1016\/j.ijscr.2016.08.043","article-title":"Synovial sarcoma of the hypopharynx in a pediatric patient: case report","volume":"28","author":"Alotaibi","year":"2016","journal-title":"Int J Surg Case Rep."},{"key":"B2","article-title":"Synovial cell sarcoma","volume-title":"StatPearls","author":"Mangla","year":"2025"},{"key":"B3","first-page":"80","volume-title":"WHO Classification of Tumours of Soft Tissue and Bone","author":"Fletcher","year":"2013"},{"key":"B4","doi-asserted-by":"publisher","first-page":"159","DOI":"10.1177\/1093526620981368","article-title":"Primary knee intra-articular synovial sarcoma in pediatric and adolescent patients","volume":"24","author":"Cao","year":"2021","journal-title":"Pediatr Dev Pathol"},{"key":"B5","doi-asserted-by":"publisher","first-page":"e70207","DOI":"10.1002\/cam4.70207","article-title":"The impact of margins and re-resection in pediatric synovial sarcoma","volume":"13","author":"Espinoza","year":"2024","journal-title":"Cancer Med"},{"key":"B6","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1007\/s00590-017-2019-4","article-title":"Pediatric soft tissue sarcoma of the limbs: clinical outcome of 97 patients","volume":"28","author":"Sambri","year":"2018","journal-title":"Eur J Orthop Surg Traumatol"},{"key":"B7","doi-asserted-by":"publisher","first-page":"289","DOI":"10.1038\/s41591-020-01212-6","article-title":"Opposing immune and genetic mechanisms shape oncogenic programs in synovial sarcoma","volume":"27","author":"Jerby-Arnon","year":"2021","journal-title":"Nat Med"},{"key":"B8","doi-asserted-by":"publisher","first-page":"43","DOI":"10.1080\/14728214.2019.1591367","article-title":"Standard treatment and emerging drugs for managing synovial sarcoma: adult\u2019s and pediatric oncologist perspective","volume":"24","author":"Baldi","year":"2019","journal-title":"Expert Opin Emerg Drugs"},{"key":"B9","doi-asserted-by":"publisher","first-page":"101622","DOI":"10.1016\/j.rmcr.2022.101622","article-title":"Pediatric pleuropulmonary synovial sarcoma: a case report in a recurrent spontaneous pneumothorax","volume":"36","author":"Patel","year":"2022","journal-title":"Respir Med Case Rep"},{"key":"B10","doi-asserted-by":"publisher","first-page":"e28411","DOI":"10.1097\/MD.0000000000028411","article-title":"Primary pharyngeal synovial sarcoma in a pediatric patient: a case report","volume":"100","author":"Bae","year":"2021","journal-title":"Medicine (Baltimore)"},{"key":"B11","doi-asserted-by":"publisher","first-page":"110471","DOI":"10.1016\/j.ijporl.2020.110471","article-title":"Pediatric laryngeal sarcoma: systematic review and pooled analysis","volume":"139","author":"Mur","year":"2020","journal-title":"Int J Pediatr Otorhinolaryngol"},{"key":"B12","doi-asserted-by":"publisher","first-page":"1078","DOI":"10.3389\/fonc.2019.01078","article-title":"Epigenetic targets in synovial sarcoma: a mini-review","volume":"9","author":"Hale","year":"2019","journal-title":"Front Oncol"},{"key":"B13","doi-asserted-by":"publisher","first-page":"82","DOI":"10.5146\/tjpath.2018.01449","article-title":"Pediatric tonsillar synovial sarcoma-very rare localization: a case report and review of the literature","volume":"36","author":"Yal\u00e7\u0131n","year":"2020","journal-title":"Turk Patoloji Derg"},{"key":"B14","doi-asserted-by":"publisher","first-page":"229","DOI":"10.1007\/s11864-023-01056-5","article-title":"Relapsed synovial sarcoma: treatment options","volume":"24","author":"Weiss","year":"2023","journal-title":"Curr Treat Options Oncol"},{"key":"B15","doi-asserted-by":"publisher","first-page":"75","DOI":"10.1007\/s13193-013-0285-0","article-title":"Synovial sarcoma oropharynx\u2014a case report and review of literature","volume":"5","author":"Kadapa","year":"2014","journal-title":"Indian J Surg Oncol"},{"key":"B16","doi-asserted-by":"publisher","first-page":"283","DOI":"10.1186\/s12891-020-03312-3","article-title":"Synovial sarcoma presenting as an intra-articular mass in a pediatric patient: a case report","volume":"21","author":"Al-Mohrej","year":"2020","journal-title":"BMC Musculoskelet Disord"},{"key":"B17","doi-asserted-by":"publisher","first-page":"758","DOI":"10.6004\/jnccn.2016.0078","article-title":"Soft tissue sarcoma, version 2.2016, NCCN clinical practice guidelines in oncology","volume":"14","author":"von Mehren","year":"2016","journal-title":"J Natl Compr Canc Netw"},{"key":"B18","doi-asserted-by":"publisher","first-page":"57","DOI":"10.46883\/ONC.2021.3502.0057","article-title":"Pediatric locally advanced synovial sarcoma: what would be the best treatment option?","volume":"35","author":"Petrosyan","year":"2021","journal-title":"Oncology (Williston Park)"},{"key":"B19","doi-asserted-by":"publisher","first-page":"16","DOI":"10.14423\/SMJ.0000000000001075","article-title":"Single-institution experience of synovial sarcoma","volume":"113","author":"Farkas","year":"2020","journal-title":"South Med J"},{"key":"B20","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1007\/s11912-021-01061-4","article-title":"Advances in the management of pediatric sarcomas","volume":"23","author":"Hernandez Tejada","year":"2021","journal-title":"Curr Oncol Rep"},{"key":"B21","doi-asserted-by":"publisher","first-page":"1077756","DOI":"10.3389\/fcell.2022.1077756","article-title":"Synovial sarcoma of the head and neck: a review of reported cases on the clinical characteristics and treatment methods","volume":"10","author":"Quan","year":"2023","journal-title":"Front Cell Dev Biol"},{"key":"B22","doi-asserted-by":"publisher","first-page":"e35212","DOI":"10.7759\/cureus.35212","article-title":"An extreme case of lethal abdominal compartment syndrome in pediatric patient with synovial sarcoma","volume":"15","author":"Zhang","year":"2023","journal-title":"Cureus"},{"key":"B23","doi-asserted-by":"publisher","first-page":"e31038","DOI":"10.1002\/pbc.31038","article-title":"Treatment at relapse for synovial sarcoma of children and adolescents: a multi-institutional European retrospective analysis","volume":"71","author":"Ferrari","year":"2024","journal-title":"Pediatr Blood Cancer"},{"key":"B24","doi-asserted-by":"publisher","first-page":"1123464","DOI":"10.3389\/fonc.2023.1123464","article-title":"Emerging targeted and cellular therapies in the treatment of advanced and metastatic synovial sarcoma","volume":"13","author":"Fuchs","year":"2023","journal-title":"Front Oncol"},{"key":"B25","doi-asserted-by":"publisher","first-page":"1615945","DOI":"10.3389\/fonc.2025.1615945","article-title":"Case report: diagnostic pitfalls in soft tissue tumors: synovial sarcoma masquerading as venous malformation","volume":"15","author":"Jiang","year":"2025","journal-title":"Front Oncol"}],"container-title":["Frontiers in Pediatrics"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fped.2025.1636916\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,13]],"date-time":"2025-10-13T04:17:10Z","timestamp":1760329030000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fped.2025.1636916\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,10,13]]},"references-count":25,"alternative-id":["10.3389\/fped.2025.1636916"],"URL":"https:\/\/doi.org\/10.3389\/fped.2025.1636916","relation":{},"ISSN":["2296-2360"],"issn-type":[{"value":"2296-2360","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,10,13]]},"article-number":"1636916"}}