Metastatic synovial sarcoma with cervical spinal cord compression treated with posterior ventral resection: Case report

Context: Synovial sarcomas, which represent 5% to 10% of all adult soft-tissue sarcomas, usually metastasize to the lungs. Metastasis to the spine is rare. Spinal cord compression due to spinal metastasis occurs in approximately 3% of patients with extraspinal soft-tissue sarcomas. Method: Case report. Findings: A 26-year-old woman presented with neck pain, arm weakness, and a history of metastatic synovial sarcoma originating at the right knee. Computed tomography revealed destruction of the odontoid and C2 body. Magnetic resonance imaging revealed tumor in the posterior elements of C2 and in the ventral epidural space from C2-C5. She was treated with C2-C3 laminectomy, posterior C2 corpectomy with occipital-C7 fixation, and fusion. Postoperatively, her neck pain resolved and left upper extremity strength returned to normal. Conclusion and Clinical Relevance: Metastatic spinal cord compression from synovial sarcoma is rare. Surgical resection can lead to neurologic improvement.