Synovial sarcomas are rare, aggressive malignant neoplasms, and less than 10% of cases involve the head and neck. Cases that involve the nasopharynx are even more exceptional and little information is available concerning their diagnosis and management. We report the third case of synovial sarcoma of the nasopharynx, which was diagnosed as a monophasic type and was successfully treated with a complete surgical excision followed by irradiation. The present case indicates that appropriate immunohistochemical and cytogenetic analysis are essential for accurate diagnosis of monophasic synovial sarcoma in unusual locations. A review of the literature indicates that synovial sarcoma of the nasopharynx exhibits an improved prognosis following tumor resection and postoperative adjuvant radiation unless it invades adjacent bones, even though the tumor is larger than 4 cm.
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