Dr. Francisco Bengoa
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Soft-tissue tumors

Synovial sarcoma

Soft tissueMalignant / sarcomaTumours of uncertain differentiation

Epidemiology

A sarcoma of young adults, often near the joints of the limbs. The name does not mean it arises from the synovial membrane; a deep mass near a joint in young adults warrants suspicion.

Basic features

A deep mass that may grow slowly and mimic a benign lesion; it is confirmed by the characteristic SS18::SSX1 or SS18::SSX2 fusion, which specific immunohistochemistry can now also detect.

Usual treatment

Wide resection, radiotherapy, and chemotherapy in higher-risk cases or large tumors. Before chemotherapy starts it is worth discussing fertility preservation with the team, because some of these treatments can affect it and the options have to be raised beforehand.

Outcomes and prognosis

Survival declines over the years because it can recur or spread late; for that reason it requires prolonged surveillance, often for 10 years or more.

Warning signs

These signs do not necessarily mean cancer, but they warrant evaluation before operating on or needling a mass.

  • A soft-tissue mass that grows, is larger than 5 cm, or is deep.
  • Persistent, night-time or progressive bone pain, especially if it limits activity.
  • A fracture from minimal trauma, or an aggressive bone lesion on an X-ray.
  • A lump that comes back after previous surgery.
  • Neurological symptoms, rapid swelling, or pain associated with a mass.

This information is general and does not replace a medical evaluation. A musculoskeletal tumor must be interpreted together with imaging, physical examination, biopsy when appropriate and each patient's context.

Specialist evaluation

If you have a mass, a bone lesion or a report suggesting a tumor, book an evaluation.

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