Discussion
Head and neck region has a unique anatomy that causes variable tumor
types originated from muscle, adipous tissue, nerve sheath, vessels and
other tissues. Sarcomas are highly heterogenous tumors with different
outcome. There are 50 histologic subtypes of sarcoma according to the
WHO classification (5). The sarcomas in adults occur 5-15% in the head
and neck region (6). The most common sarcomas detected in the head and
neck region are osteosarcoma, rhabdomyosarcoma, undifferentiated
pleomorphic sarcoma, fibrosarcoma and angiosarcoma(7). The most common
sarcoma subtype in head and neck region is rhabdomyosarcoma and this
followed by osteosarcoma (7). In our study the most common sarcoma was
rahabdomyosarcoma (29 %) and the others were malign mesanchimal tumor,
pleomorphic sarcoma, leiomyosarcoma, primitive neuroectodermal tumor,
rhabdomyosarcoma, chondrosarcoma, snovial sarcoma, osteosarcoma.
Tumor site is an important factor in decision of surgery. This factor
affects the surgical type, clear margins and aesthetic outcomes.
The most commonly seen sarcomas were compatible with the literature.
Wide surgical resection with tumor free margins is the best approach for
these tumors. Local recurrence rates are high due to rapid growth
pattern and high potential for distant metastasis. Multidisciplinary
approach is essential for these cases. This approach improve quality of
life and cosmetic results and also increases functionality. Primary goal
of the treatment of head neck sarcomas is local control. Local control
rates are very high in head and neck sarcomas(8). Local control rates
were found and has been reported in 47 % to 78 % of the cases(9-10).
However overall survival rates are poorer at head and neck region than
other locations. Five years overall survival was found between 31 % to
80% in some studies(5,9,10) .
In conclusion, sarcomas of the head and neck region are relatively rare
tumors. Local recurrence rates are high. Radical resection of the tumors
is essential for these cases. However due to the very high risk of local
recurrence and distant metastasis the management of these patients need
multidisciplinary approach. These cases must be discussed in
multidisciplinary tumor boards and treatment must be individualized
according to tumor subtype, localization and patient specific
co-morbidities.