Introduction
Tumors in the soft tissue can be cancerous or non-cancerous. The term sarcoma is added to any name indicating that it is cancer that has its beginning in the tissues of bones or muscles, but mostly soft tissues in this case. It is called soft tissue sarcoma, when the sarcomas are found in soft tissues like blood vessels, deep skin tissues, fat, muscle, or nerves. Synovial sarcoma is a type of soft tissue sarcoma. The other types of soft tissue sarcoma include clear cell sarcoma, alveolar soft part sarcoma, rhabdomyosarcoma, etc.
What Is Synovial Sarcoma?
Synovial sarcoma is also known as malignant synovioma. Cancer, referred to as synovial sarcoma, can start from many types of soft tissues, like muscles or joints. It is a misnomer that synovial sarcomas are present in the areas of the synovium. It can occur at any place in the body. This soft tissue synovial sarcoma originates primarily in the legs, close to the wrist joints or ankle joints, and arms. The other places can be lung and abdomen soft tissues.
What Are the Causes of Synovial Sarcoma?
The main or exact reason for the synovial sarcoma is yet to be known. But this sarcoma is linked to changes in individual genes. The mutations or modifications in the genes have become the reason for the development of this disease in the human body. When an SYT (synovial sarcoma translocation) gene is paired with a faulty gene (SSX gene), the body develops a modified gene, causing synovial sarcoma.
Does Synovial Sarcoma Spread From Parents to Children?
Though synovial sarcoma is said to occur in patients with changed genes, it does not run in families. Genetic factors can show their effect in increasing the chance of the development of synovial sarcoma. It is not necessary that a parent suffering from synovial sarcoma will pass on the condition to their offspring.
Who Is Most Commonly Affected With Synovial Sarcoma Occur?
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Five percent to ten percent of soft tissue cancers are synovial sarcomas.
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Synovial sarcoma can occur everywhere and anywhere in the body and is not dependent on age, meaning it can occur at any age.
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However, most frequently, it is observed in young people and also in terms of gender; males are slightly more affected compared to females.
What Are the Types of Synovial Sarcoma?
There are two types of synovial sarcoma. They are:
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Monophasic -
In this type, the tumors are made up of cells called spindle cells. These cells look elongated and narrow in a microscope.
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Biphasic -
In this, the spindle and epithelial cells (cells which form protection cover to the body surface) are found.
Both types are very similar; hence, the effect on the body and treatment is also the same.
What Are the Signs and Symptoms of Synovial Sarcoma?
Signs and symptoms depend on the location of the sarcoma.
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The presence of sarcoma at a region near the nerve can cause pain, senselessness, or numbness.
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A painless bulge or mass in the knee, shoulder, or hip regions.
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Sudden sharp pain in the areas in which the bulge is present.
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There are chances of swelling also occurring in the same region.
How Is Synovial Sarcoma Diagnosed?
The following are the diagnostic methods for diagnosing synovial sarcoma:
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X-ray - Synovial sarcoma, a soft tissue sarcoma, cannot always be visualized with the help of X-rays. However, using X-rays is a conventional method of diagnosis as few tumors are lined by a calcified border that can be detected on a plain X-ray.
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Ultrasound - Ultrasound uses sound waves to digitally visualize the soft tissue alterations.
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CT (Computed Tomography) Scan: CT scan uses X-rays and digital mode to visualize the defect. These can be useful to determine the border or extent of the tumor.
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MRI (Magnetic Resonance Imaging) - A tumor in a region where the blood vessels, soft tissues, and nerves are present. MRI helps in detecting the effect of the tumor on those adjacent structures.
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Biopsy: The tumor cells are collected from the site, and the pathologist examines them under a microscope to determine the type of tumor.
What Is the Treatment for Synovial Sarcoma?
Treatment for synovial sarcoma depends on the extent and severity of the disease and its spread. It is proven that there is a higher chance of cancer already spreading before the diagnosis. Following are the treatment modalities that are followed.
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Surgery: The success of any surgery depends on the approach as well as the clinical condition of the patient. A surgical procedure is followed in which the entire tumor is removed. Removal of the entire tumor in any part of the body increases the patient's survival rate.
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Chemotherapy: It is a process of using high-dosage anti-cancer drugs to eradicate tumors. Chemotherapy can be given before or after the surgery. Adjuvant chemotherapy is given after a surgical procedure to improve the outcome of the treatment. It is mainly used to remove the leftover tumor parts that cannot be removed by surgical procedure or when the tumor is spreading. The benefits and risks due to chemotherapy should be discussed with the physician.
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Radiotherapy: Radiotherapy is a process of removing cancer cells using high-intensity radiation. It is also a treatment aiming to prevent the recurrence of the tumor.
What Is the Prognosis of Synovial Sarcoma?
Estimating the effect of a disease on a long-term basis is known as prognosis. Prognosis is affected by many factors, such as:
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The location of the tumor in the body.
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The spread of tumors to other parts of the body.
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The extent of the tumor was resolved or removed after the surgical procedure.
Considering all these factors, the recovery rate varies. As the newer treatments for synovial sarcoma are still being researched, the possibilities of good prognosis are less. However, survival rates range from 36 % to 76 % in patients suffering from synovial sarcoma who will be alive for five years.
Conclusion
Though synovial sarcoma is a rare tumor, the effect of the tumor directly disturbs the lifespan of the patient. Therefore, it is necessary to consult the physician immediately upon noticing the symptoms. The majority of cancer is cured with the help of surgery and chemotherapy. However, Radiotherapy is advised depending on the severity of the disease and the patient's clinical condition.
