Posters
« Back
The Misleading Sarcoma - Synovial Sarcoma
EP34229
Poster Title: The Misleading Sarcoma - Synovial Sarcoma
Submitted on 26 Oct 2020
Author(s): Seong Hwan Shin, David Yu
Affiliations: Brighton and Sussex University Hospitals NHS Trust
Poster Views: 40
View poster »


Poster Information
Abstract: The Misleading Sarcoma – Synovial Sarcoma

Learning objectives
Synovial sarcoma is the third most common soft-tissue sarcoma. Nomenclature suggests disease to arise from intra-articular origin, however this is not often the case. Its name and characteristics can be misleading and mistaken diagnosis can be made. We present a series of cases with the purpose of increasing recognition and improving the overall assessment of synovial sarcoma.

Background
Synovial sarcoma is an aggressive disease with high tendency for early metastasis. Extremities and juxta-articular locations are most frequent, however other unusual locations include head, neck and thorax. Synovial sarcoma comprises of mesenchymal cells however the misnomer arises from its resemblance to synovial cells. Despite the name, there is no involvement of the synovium. Furthermore, its slow growing nature and initial benign radiological appearances can further lead to misdiagnosis.

Imaging findings
MRI is the preferred modality for assessment of synovial sarcoma. We identified 6 cases of synovial sarcoma involving the extremities. 2 cases showed well defined smaller lesions (<2.2cm) demonstrating early stages of the disease. 4 cases involved large multilobulated lesions (4cm to 20cm), deep seated and juxta articular. The triple sign was seen consisting of varying signal intensity areas in T2 weighted image. Aggressive bony invasion was demonstrated in 1 case.

Conclusion
Synovial sarcoma is often a high grade lesion manifesting to aggressive disease and early metastasis leads to a guarded prognosis. The misnomer and its insidious course can lead to misdiagnosis at the initial presentation. Therefore
highlighting the spectrum of radiological appearances will improve diagnosis and patient management.
Summary: Synovial sarcoma is the third most common soft-tissue sarcoma and can be an aggressive disease with high tendency for early metastasis. However, its name and characteristics can be misleading and mistaken diagnosis can be made. We present a series of cases with the purpose of increasing recognition and improving the overall assessment of synovial sarcoma. References: 1. Bakri, A., Shinagare, A., Krajewski, K., Howard, S., Jagannathan, J., Hornick, J. and Ramaiya, N. (2012). Synovial Sarcoma: Imaging Features of Common and Uncommon Primary Sites, Metastatic Patterns, and Treatment Response. American Journal of Roentgenology, 199(2), pp.W208-W215.

2. Murphey, M., Gibson, M., Jennings, B., Crespo-Rodríguez, A., Fanburg-Smith, J. and Gajewski, D. (2006). Imaging of Synovial Sarcoma with Radiologic-Pathologic Correlation. RadioGraphics, 26(5), pp.1543-1565.

3. Miettinen, M. (1991). Keratin subsets in spindle cell sarcomas. Keratins are widespread but synovial sarcoma contains a distinctive keratin polypeptide pattern and desmoplakins. The American Journal of Pathology, 138(2), pp.505-513.
Report abuse »
Questions
Ask the author a question about this poster.
Ask a Question »

Creative Commons