Can Synovial Sarcoma Be Cured?

The term synovial sarcoma is a misnomer because this cancer does not arise from synovial tissue (tissue lining the cavities of joints, tendon sheaths, and bursae) as was previously thought. Instead, synovial sarcoma or synovial cell sarcoma is a type of cancer arising from soft tissues (such as the muscles, tendons, and ligaments). 

It is one of the rarest types of cancer that affects about 1-2 individuals out of every million people in the United States. 

Synovial sarcoma often occurs within the first 30 years of life and affects men more than women. It is typically not inherited, and the affected patient may not have family members with a history of the cancer.

Synovial sarcoma generally does not cause symptoms during the initial stages. Usually, the patient reports:

• A small lump, often painless, that has rapidly increased in size
• As the tumor increases in size, it may cause symptoms such as pain, numbness, and reduced range of motion

Synovial sarcoma can occur in any part of the body, but it is most commonly located around the:

• Knees
• Arms
• Legs
• Feet 
• Wrists
• Ankles

Synovial sarcoma may also occur in the hands, lungs, or abdomen.

Doctors decide on a treatment plan based on factors such as the site of synovial sarcoma, its stage, the patient’s age, preferences, and whether there are any underlying health conditions.

The primary treatment for synovial sarcoma involves surgical removal of the entire tumor along with a margin of surrounding healthy tissue. This ensures that all the cancerous tissue has been removed from the site. Surgical removal gives better outcomes when the tumor has not spread to other sites in the body (metastasized). Moreover, surgical removal depends on the site where the tumor is present. If the tumor is at an inoperable site, it may not be removed by surgery.

Doctors may also consider other therapy options with or without surgery: 

• Radiation therapy before or after the surgery to kill the sarcoma cells
• Chemotherapy if the sarcoma has spread in the body or cannot be completely removed by surgery

Studies have suggested that about 36% to 76% of patients with synovial sarcoma live for at least 5 years after their first diagnosis. They may need to follow up with their doctors to detect and treat recurrence at an early stage.

Synovial sarcoma may be diagnosed by:

• Taking a detailed medical history and performing a physical examination
• Performing imaging tests including X-ray, computed tomography (CT) scan, ultrasonography, and magnetic resonance imaging (MRI) scan
• Performing tumor biopsy (collecting a small sample of the tumor tissue and examining it under a microscope)
• Conducting cytogenetic analysis that involves detecting specific chromosomal abnormalities (such as chromosomal translocation between the X chromosome and chromosome 18)

Timely diagnosis is the key to proper treatment. A painless lump anywhere in the body must be investigated as soon as possible.