Learning objectives
To recognize the typical imaging findings of synovial sarcomas with emphasis on the upper limbs.
Background
Synovial sarcomas (SS) are tumors of mesenchymal and epithelial origin and is the fourth most common type of soft-tissue sarcoma,
accounting for 8%–10.5% of all primary soft-tissue sarcomas.
SS occur in any age,
but mostly in adolescents and young adults (15–40 years of age).
They are the most common sarcoma subtype in the adolescent population.
Despite its name,
is not related to synovial tissue and does not commonly arise in an intraarticular location,
but usually occurs near joints.
SS can appear in almost any anatomical...
Findings and procedure details
· Radiograph
Radiopgraph is usually the first imaging exam performed when patients seek medical attention.
They are normal in about 50% of cases,
particularly when lesions arel small.
Plain radiograph usually show a non-specific round to oval soft-tissue lesion,
usually close to articulations.
Calcification are identified in up to 30%,
and are often eccentric or peripheral within the mass.
Chondroid or osteoid mineralization is rare.
Bone involvement is not rare,
but as SS growth is usyally slow,
when in contact with bones it most commonly...
Conclusion
Synovial sarcomas are rare and aggressive tumors.
It should always be considered in the differential diagnosis of young adults presenting with a periarticular mass,
particularly if it contains calcifications.
Although less common in the upper limbs,
as we showed here,
SS are a relevant differential diagnosis of lesions in these sites and its features should to be known by the radiologist.
The diagnosis of synovial sarcoma should also be considered when small periarticular masses are found and should be differentiated from other cystic lesions.
Finally,...
References
1. Van Tine SSABA.
Synovial Sarcoma: Current Concepts and Future Perspectives.
2017 Dec 4;:1–9.
2. Bakri A,
Shinagare AB,
Krajewski KM,
Howard SA,
Jagannathan JP,
Hornick JL,
et al.
Synovial sarcoma: imaging features of common and uncommon primary sites,
metastatic patterns,
and treatment response.
AJR Am J Roentgenol.
2012 Aug;199(2):W208–15.
3. Krieg AH,
Hefti F,
Speth BM,
Jundt G,
Guillou L,
Exner UG,
et al.
Synovial sarcomas usually metastasize after >5 years: a multicenter retrospective analysis with minimum follow-up of 10 years for survivors.
Annals...