• Synovial Sarcoma Overview

    Synovial sarcoma is a serious condition that affects the soft tissues of the body. The rare, malignant tumors most often occur near the knee, but also near other joints in the arms and legs. Affecting young children, adolescents and young adults, synovial sarcoma can spread to the lungs and, less often, nearby lymph nodes. Small tumors that can be surgically removed are easier to treat than larger tumors, tumors that cannot be removed with surgery, or those that have spread.

    Synovial Sarcoma Treatment at Dana-Farber/Boston Children’s 

    Children and young adults with synovial sarcoma are treated at Dana-Farber/Boston Children’s Cancer and Blood Disorders Center through our Bone & Soft Tissue Program. Continue reading to learn more about synovial sarcoma or visit the Bone & Soft Tissue Program homepage to learn about our expertise and treatment options for this condition.

    Symptoms & Diagnosis

    The symptoms of synovial sarcoma can resemble those of arthritis, bursitis or synovitis. Because it is a slow-growing tumor, a  child may not have or notice symptoms for some time, resulting in a delayed diagnosis. The most common symptoms are:

    • Swelling
    • A mass that may or may not be accompanied by pain
    • Limping or difficulty using the arms, legs, hands or feet

    In addition to a complete physical examination, synovial sarcoma is diagnosed with:

    • X-ray
    • Magnetic resonance imaging (MRI)
    • Computerized tomography (CT or CAT) scan
    • Biopsy
    • Bone scan to determine the cause of pain and inflammation
    • Complete blood count and other blood tests

    After all tests are completed, doctors will be able to outline the best treatment options.

    Treatment & Care Options

    Treatment of synovial sarcoma may involve a combination of surgery, radiation therapy and/or chemotherapy:

    • Surgery – depending on the size and location of the tumor, this may be either limb-salvage surgery to remove the tumor and a wide area of healthy surrounding tissue or amputation if the tumor involves major nerves and blood vessels
    • Radiation therapy – targeted radiation to kill cancer cells left behind after surgery; can also be given before surgery to shrink the tumor
    • Chemotherapy 

    Progressive or Recurrent Disease

    Most recurrent disease that has spread occurs within the first two years after treatment, but late recurrences—up to five years later—have been reported. The risk of local recurrence is in direct proportion to the amount of tumor removed with surgery.

    Long-term Outlook

    As treatment advances have been made, long-term outcomes for patients with synovial sarcoma have improved in the last 20 years. Outcomes vary depending on the size of the tumor. Surgery can cure the disease in anywhere from 20 percent to 70 percent of cases. Spreading of the disease to distant sites carries a two-year survival rate of only 25 percent.
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