- What is synovial sarcoma?
Synovial sarcoma is a type of soft tissue sarcoma. Soft tissue sarcomas
are cancers
of the muscle, fat, fibrous
tissue, blood
vessels, or other supporting tissue of the body, including synovial tissue.
Synovial tissue lines the cavities of joints, such as the knee or elbow, tendons
(tissues that connect muscle to bone), and bursae (fluid-filled,
cushioning sacs in the spaces between tendons, ligaments, and bones). Although
synovial sarcoma does not have a clearly defined cause, genetic
factors are believed to influence the development of this disease.
- How often does synovial sarcoma occur?
Synovial sarcoma is rare. It accounts for between 5 and 10 percent of the
approximately 10,000 new soft tissue sarcomas reported each year (1). Synovial
sarcoma occurs mostly in young adults, with a median
age of 26.5 (1). Approximately 30 percent of patients with synovial sarcoma
are younger than 20. This disease occurs more often in men than in women (1).
- Where does synovial sarcoma develop?
About 50 percent of synovial sarcomas develop in the legs, especially the
knees. The second most common location is the arms (2). Less frequently, the
disease develops in the trunk, head and neck region, or the abdomen
(1, 2). It is common for synovial cancer to recur
(come back), usually within the first two years after treatment. Half of the
cases of synovial sarcoma metastasize
(spread to other areas of the body) to the lungs,
lymph
nodes, or bone
marrow (1).
- What are the symptoms of synovial sarcoma?
Synovial sarcoma is a slow-growing tumor.
Because it grows slowly, a person may not have or notice symptoms for some
time, resulting in a delay in diagnosis.
The most common symptoms of synovial sarcoma are swelling or a mass that may
be tender or painful (1). The tumor may limit range of motion or press against
nerves
and cause numbness. The symptoms of synovial sarcoma can be mistaken for those
of inflammation
of the joints, the bursae, or synovial tissue. These noncancerous conditions
are called arthritis,
bursitis,
and synovitis,
respectively.
- How is synovial sarcoma diagnosed?
The doctor may use the following procedures and tests to diagnose synovial
sarcoma:
-
Biopsy:
Tissue is removed for examination under a microscope.
-
Immunohistochemical analysis:
Tumor tissue is tested for certain antigen
and antibody
interactions common to synovial sarcoma.
-
Ultrastructural findings: The tissue is examined using
an ultramicroscope and electron
microscope.
-
Genetic
testing: Tissue is tested for a specific chromosome
abnormality common to synovial sarcoma.
- How is synovial sarcoma treated?
The type of treatment depends on the age of the patient, the location of
the tumor, its size, its grade
(how abnormal
the cancer cells
look under a microscope and how likely the tumor will quickly grow and spread),
and the extent of the disease. The most common treatment is surgery to remove
the entire tumor with negative margins
(no cancer cells are found at the edge or border of the tissue removed during
surgery). If the first surgery does not obtain negative tissue margins, a
second surgery may be needed.
The patient may also receive radiation
therapy before or after surgery to control the tumor or decrease the chance
of recurrence
(cancer coming back). The use of intraoperative
radiation therapy (radiation aimed directly at the tumor during surgery)
and brachytherapy
(radioactive material sealed in needles, wires, seeds, or catheters,
and placed directly into or near a tumor) are under study.
Patients may also receive chemotherapy
alone or in combination with radiation therapy.
- Are clinical trials (research studies) available?
Where can people get more information about clinical trials?
Yes. Participation in clinical trials is an important treatment option for
many people with synovial sarcoma. Studies are in progress to determine the
effectiveness of biological
therapies (treatment to stimulate or restore the ability of the immune
system to fight cancer), including monoclonal antibodies, and chemotherapy
with hyperthermia (kills tumor cells by heating them to several degrees above
body temperature).
People interested in taking part in a clinical trial should talk with their
doctor. Information about clinical trials is available from the NCI's Cancer
Information Service (CIS) (see below) at 1–800–4–CANCER
and in the NCI booklet Taking Part in Cancer Treatment Research Studies,
which can be found at http://www.cancer.gov/publications
on the Internet. This booklet describes how research studies are carried out
and explains their possible benefits and risks. Further information about
clinical trials is available at http://www.cancer.gov/clinicaltrials
on the NCI's Web site. The Web site offers detailed information about specific
ongoing studies by linking to PDQ®,
the NCI's cancer information database. The CIS also provides information from
PDQ.
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