Synovial Sarcoma

What Is a Synovial Sarcoma?

Synovial sarcoma is a rare type of soft tissue sarcoma. Despite its name, it does not occur in the synovium (lining) of joints. Synovial sarcomas typically occur in the extremities and present in young adulthood.

Who Do Synovial Sarcomas Affect?

While these tumours can develop at any age, it is most common in persons between the ages of 15 and 40.

What Causes a Synovial Sarcoma?

The cause of synovial sarcoma is unknown.

Doctors understand that cancer starts when a cell's DNA changes. The DNA of a cell includes the instructions that tell it what to do. The changes cause the cell to grow rapidly, resulting in a swarm of abnormal cells (tumour).

The cells have the ability to penetrate and destroy healthy tissue nearby. Cancer cells can break away and spread to other regions of the body, such as the lungs and bones, over time.

Symptoms of a Synovial Sarcoma

Early on, you might not notice any signs or symptoms. However, when these tumours progress, you may notice a lump or swelling underneath the skin.

Synovial sarcomas most commonly occur in the soft tissues surrounding your hip, knee, ankle, or shoulder joints. These tumours can develop large enough to make it difficult to move, or they might push on nerves, causing numbness or pain.

How is Synovial Sarcoma Diagnosed?

Doctors use a variety of tests to confirm a synovial sarcoma diagnosis. These tests include the following:

• Physical Exam: During a physical exam, a doctor looks at and assesses the tumour.
• Imaging Tests: Tests such as CT and MRI scans help doctors locate the tumour and determine if it is cancerous or benign.
• Biopsy: A doctor uses a needle to take a sample of tissue from the tumour. Reviewing the cell sample under a microscope can identify features of synovial sarcoma.

Surgical Treatment for Synovial Sarcoma

The type of treatment your doctor suggests is determined by the following factors:

• The location of your tumour
• If the tumour has progressed
• Your general health and age

The most common treatment for synovial sarcoma is surgical removal of the tumour.

The aim of surgery is to remove the tumour with a margin of normal surrounding tissue if possible. This improves the chance of cure and reduces the risk of the tumour re-occurring.

Sometimes, radiation therapy or chemotherapy is given before surgery to help shrink the tumour.

Radiation Therapy

Radiation therapy uses high-powered beams of energy, such as X-rays or protons, to kill cancer cells. The use of radiotherapy for these tumours is common. Radiotherapy (either before or after surgery) is useful in the management of sarcomas. It has been shown to reduce the chance of the tumour re-occurring locally after surgical resection.

Chemotherapy

Chemotherapy is a medicinal treatment that kills cancer cells by using chemicals. It can be taken as a pill, injected into a vein (intravenously), or both. Synovial sarcomas are sensitive to chemotherapy compared with most types of sarcoma.

Chemotherapy is sometimes given before surgery to shrink cancer and make it easier to remove during surgery. Chemotherapy is also used after surgery to improve cancer survival.

Chemotherapy and radiation can be used together.