In imaging studies,
plain radiography may be normal if the lesion is small,
deep,
and / or close to an anatomical complex; if it is larger and palpable,
the lesion is defined and of average consistency close to a joint,
it may or may not have amorphous bone erosions; there is rarely subperiosteal reaction and compromise to endosteum and bone marrow (5).
Ultrasound shows images of solid mass of soft,
hypoechoic,
nodular,
round or lobulated parts,
generally heterogeneous with mixed structural pattern,
not very aggressive appearance.
Synovial Sarcoma in Computed Tomography will show solid lesions in soft,
heterogeneous parts with attenuation coefficients similar to muscle with nodular appearance,
lobed and defined in their contours with smooth edges more or less defined and encapsulated.
According to the size of the lesion,
a more heterogeneous pattern is added due to the necrosis and hemorrhage,
giving a cystic appearance in some sites of the mass; This type of study also helps us to assess calcifications and especially the commitment to bone; what indirectly predicts its prognosis and aggressiveness helped to evaluate its treatment.
Logically,
the use of contrast material helps even more and better to assess the characteristics of the tumor.
The use of Magnetic Resonance Imaging is the study of choice for better evaluation in this type of tumors,
on T1-weighted,
is heterogeneous,
isointense or higher.
On T2-weighted is hight signal intensity and heterogeneous.
The images are lobed,
septate nodes more or less defined of different size and intensity,
thus solid,
cystic or pseudocystic lesions were found,
depending on the cellularity,
hemorrhage or necrosis; the intensity of the lesions (low,
intermediate and high) are described as Triple Sign,
mentioned by Jones and Cols.
The observed lesions were heterogeneous in the different sequences,
similar or very similar to the muscle tissue,
adding images that helped to better define the structural pattern and tissue differentiation.
with its different modalities,
simple and with contrast material were used in our study; they were included only three Angioresonances.
In our retrospective study with 43 patients in the last 3 years,
with Synovial Sarcoma with Histopathological and Immunohistochemical diagnosis.
The 43 patients who arrived at our Hospital,
were almost all of them previously handled and treated in different ways,
in our Institution the diagnosis was corroborated and the appropriate treatment and follow-up.
Of the 43 cases,
the younger patient was 17 years old and the older was 62 years old; being the average age of 34 years old. 24 patients were Female (55%.) and 19 male (44%.)
In extremities,
30 patients (69%)
In the Thorax,
11 patients including costal wall (25.5%)
in pelvis, 2 patients (4.6%).
The vast majority of patients have recurrences and lung metastases
HISTOPATHOLOGY AND IMMUNOHISTOCHEMISTRY.
Monophasic subtype: 22 patients.
(51%).
Biphasic subtype: 6 patients (13.9%).
Undifferentiated and / or poorly differentiated: 15 patients (34.8%).