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.