Synovial sarcoma

Synovial sarcoma (malignant synovioma) is a soft tissue tumor that forms from the synovial membranes of large joints, fascia, tendon and muscle tissue. The pathological process disrupts the growth and development of cells, leading to their anaplasia.

Very often, synovial sarcoma develops without a capsule. Histological examination revealed that the tumor is brownish-red, with cysts and cracks. Sarcoma progresses and involves bone tissue in the tumor process, completely destroying it. Most often, this disease occurs in patients aged 15 to 20 years, both men and women. Sarcoma metastasizes to the lungs, regional lymph nodes and bones.

Joint sarcoma is very rare. The disease can be primary or associated with synovial chondromatosis. Joint sarcoma is a malignant neoplasm consisting of mesenchymal cells. As a rule, the disease is localized near the fascia or tendons, but it can occur inside the joint or in adjacent areas. The lower extremities are most susceptible to joint sarcoma. Most often, the tumor is diagnosed in patients aged 15 to 40 years.

Causes of synovial sarcoma

The main causes of synovial sarcoma have not been clarified to this day. But there are risk factors that contribute to the appearance of the tumor, these include:

• Hereditary predisposition – some types of sarcoma, including synovial sarcoma, can be transmitted as genetic syndromes and diseases.
• Exposure of the body to high doses of radiation.
• Effects of carcinogens (chemical compounds) on the body.
• Conducting immunosuppressive therapy in the treatment of cancer tumors.

[ 1 ], [ 2 ], [ 3 ], [ 4 ], [ 5 ], [ 6 ], [ 7 ]

Symptoms of synovial sarcoma

The disease can progress slowly and be difficult to diagnose, but in some cases, synovial sarcoma manifests itself in the early stages of development. This depends on the location of the tumor. The main symptoms accompanying synovial sarcoma are pain and a tumor-like formation on a part of the body or in a joint. Limitations in movement, rapid fatigue, general weakness, weight loss. Some patients experience an increase in regional lymph nodes due to metastasis of synovial sarcoma.

Symptoms of the disease include pain and a slowly growing mass of soft tissue.

Types of synovial sarcoma

The main types of synovial sarcoma:

1. By structure:
   • Bisaphne - consists of sarcomatous and epithelial precancerous components.
   • Monophotic - similar in structure to hemangiopericytoma, contains epithelial and sarcomatous cells
2. By morphology:
   • Fibrous sarcoma - the tumor tissue is made up of fibers and is similar in structure to fibrosarcoma.
   • Cellular sarcoma consists of glandular tissue and can form cystic tumors and papillomatous neoplasms.
3. By consistency.
   • Soft – occurs in cellular sarcomas.
   • Hard – occurs when tumor tissue is saturated with calcium salts.
4. By microscopic structure:
   • Giant cell.
   • Histioid.
   • Fibrous.
   • Adenomatous.
   • Alveolar.
   • Mixed.

Sarcoma of the knee joint

Knee joint sarcoma is a malignant non-epithelial neoplasm. As a rule, knee joint sarcoma is secondary, i.e. it is the result of metastasis of another tumor formation (usually from tumors of the pelvic region). In some cases, the source of knee joint sarcoma is lesions of the popliteal lymph nodes.

Since the knee joint contains both bone and cartilage tissue, sarcoma can be osteosarcoma or chondrosarcoma. The main symptoms of the disease are impaired motor functions and the appearance of pain. If the tumor grows into the cavity of the knee joint, this causes difficulty in movement and pain at all stages of sarcoma. If the neoplasm grows outward, that is, to the skin, it can be diagnosed at an early stage. Sarcoma begins to bulge in the form of a lump, the skin under the tumor changes color, and the tumor itself is easily palpated.

If knee joint sarcoma affects tendons and ligaments, it leads to the loss of limb functions. But the articular surfaces of the knee sooner or later begin to deteriorate and reduce the motor functions of the leg to zero. Sarcoma causes swelling and pain that permeates the entire limb. Because of the tumor, the nutrition and blood supply to the parts of the leg located below the knee is disrupted.

Sarcoma of the shoulder joint

Shoulder joint sarcoma most often acts as osteogenic sarcoma or fibrosarcoma. This is a tumor-like malignant disease that affects the humerus, less often soft tissues. Sarcoma can be primary, that is, an independent disease that appeared as a result of injury, exposure to radiation, chemicals, or as a result of hereditary predisposition. But shoulder joint sarcoma can also be secondary, that is, appear as a result of metastasis of other tumor foci, for example, due to a tumor of the mammary glands or thyroid gland.

In the early stages of development, sarcoma does not cause pain and can only be diagnosed with ultrasound. But further progression of the disease causes pain, discoloration of the skin over the tumor and even deformation of the shoulder joint. Tumor treatment involves the use of surgical methods. Before and after surgery, oncologists prescribe patients a course of chemotherapy and radiation to remove cancer cells and prevent metastasis.

Diagnosis and treatment of synovial sarcoma

To diagnose the disease, X-rays and magnetic resonance imaging are performed. During treatment, surgical intervention methods are used. The patient undergoes a wide resection, which involves the removal of any lesions. Chemotherapy and radiation are used as an adjuvant therapy to combat metastasis and remaining cancer cells.

[ 8 ], [ 9 ], [ 10 ], [ 11 ]

Prognosis for synovial sarcoma

The prognosis for synovial sarcoma is unfavorable. Thus, the five-year survival rate of patients diagnosed with synovial sarcoma is 20-30%. Treatment of the neoplasm involves the use of surgical methods, chemotherapy methods and radiation.