Synovial sarcoma, also known as malignantWhen a growth in a body part is cancerous. very serious and can grow and spread very quickly to other parts of the body. synovioma, is a rare type of sarcoma (cancerA disease where abnormal cells split without control and spread to other nearby body tissue and/or organs. Cancer cells can also spread to other parts of the body through the bloodstream and lymph systems. arising from bones and/or soft tissue) that develops in the soft tissue surrounding joints in the body. It is named for its resemblance to synovial tissue, which is generally found around tendons (connective tissue that connects muscle to bone) and helps to keep joints lubricated. Despite its name, synovial sarcomas do not develop from synovial tissue.
In most cases, synovial sarcomas are found next to large joints in the body, such as the knees. They are also commonly found in the head, neck, arms, and legs. In rare cases, they may develop from soft tissue in the abdomenstomach, stomach area, belly, tummy, lung, bladderA small, elastic/muscle type sac/bag in the body, where urine (wee) is stored for urinating/weeing. Is found in the lower abdomen/belly area., and vagina.
Synovial sarcomas are more common in males, and tend to be diagnosed in teenagers and young adults. However, anyone can develop this disease.
Types of Synovial Sarcoma
There are four primary types of synovial sarcoma, which are classified by their cellular appearance under the microscope.
Biphasic Synovial Sarcoma
Biphasic synovial sarcoma is a less common subtype of synovial sarcomas that have two types of cells
• the smallest, living parts of the body. Cells work together to form or build the body
• a human is made up of millions of Cells
• Cells reproduce themselves to make sure a body stays working
• sometimes Cells can be abnormal or damaged and these can be cancer cells
in the tumour called spindle cells and epithelial cells. These tumours are often aggressive, likely to metastasiseFor cancer to spread or grow out of its original place., and can have a good prognosisTo predict how a disease/condition may progress and what the outcome might be. when found early.
Monophasic Fibrous Synovial Sarcoma
Monophasic fibrous synovial sarcomas are the most common type of synovial sarcomas that contains only spindle cells within the tumour. These tumours are often aggressive, likely to metastasise, and can have a good prognosis when found early.
Monophasic Epithelial Synovial Sarcoma
Monophasic epithelial synovial sarcoma is a very rare subtype of synovial sarcoma that contains only epithelial cells within the tumour. This type of tumour is often misdiagnosed for adenocarcinomas, which are cancers arising from mucus-producing glands in organs. There is limited information on the aggressiveness and prognosis of this subtype.
Poorly Differentiated Synovial Sarcoma
Poorly differentiated synovial sarcomas are a less common type of synovial sarcoma with varying cellular components. These tumours are often aggressive, likely to metastasise, and can have a good prognosis when found early.
Treatment
If a synovial sarcoma is detected, it will be staged and graded based on size, metastasisKnown as secondary cancer, it grows/spreads from the original/ primary cancer. (whether the cancer has spread to other parts of the body) and how the cancer cells look under the microscope. Staging and grading helps your doctors determine the best treatment for you.
Cancers can be staged using the TNM staging system:
- T (tumour) indicates the size and depth of the tumour.
- N (nodes) indicates whether the cancer has spread to nearby lymphA clear fluid that moves through the body through the lymphatic system, carrying cells that fight infection. nodes.
- M (metastasis) indicates whether the cancer has spread to other parts of the body.
This system can also be used in combination with a numerical value, from stage 0-IV:
- Stage 0: this stage describes cancer cells in the place of origin (or ‘in situ’) that have not spread to nearby tissue.
- Stage I: cancer cells have begun to spread to nearby tissue. It is not deeply embedded into nearby tissue and had not spread to lymph nodes. This stage is also known as early-stage cancer.
- Stage II: cancer cells have grown deeper into nearby tissue. Lymph nodes may or may not be affected. This is also known as localisedOnly to one area/place of body. cancer.
- Stage III: the cancer has become larger and has grown deeper into nearby tissue. Lymph nodes are generally affected at this stage. This is also known as localised cancer.
- Stage IV: the cancer has spread to other tissues and organs in the body. This is also known as advancedAt a late stage, far along or metastatic cancer.
Cancers can also be graded based on the rate of growth and how likely they are to spread:
- Grade
• A score that tells how quickly a tumour might spread and grow by looking at how the abnormal cells and tissue look under a microscope.
• Grade is not the same as stage.
• Grading is different depending on the type of cancer.
I: cancer cells present as slightly abnormal and are usually slow growing. This is also known as a low-grade tumour. - Grade II: cancer cells present as abnormal and grow faster than grade-I tumours. This is also known as an intermediate-grade tumour.
- Grade III: cancer cells present as very abnormal and grow quickly. This is also known as a high-grade tumour.
Once your tumour has been staged and graded, your doctor may recommend genetic testing, which analyses your tumour DNA and can help determine which treatment has the greatest chance of success. They will then discuss the most appropriate treatment option for you.
Treatment is dependent on several factors, including location, stage of disease and overall health.
Treatment options for synovial sarcomas may include:
- Surgery to remove as much of the tumour as possible.
- Radiation therapy.
- Chemotherapy
• a chemical drug treatment to kill or slow-growing cancer Cells
• these drugs are called cytotoxic drugs
. - Clinical trials.
- Palliative careLessening pain without curing the disease..
For more information on the treatment options, please refer to the Rare Cancers Australia Treatment Options page.
Risk factors
Because of how rare synovial sarcomas are, there has been limited research done into the risk factors of this disease.
Symptoms
Synovial sarcomas may appear asymptomatic in the early stages of disease. As the tumour progresses, the following symptoms may appear:
- A massA growth of cells that come together to make a lump, either big or small, and may or may not be cancer. that may be painful or painless.
- Bleeding from the nose, vagina, rectum, or throat (if the tumour is in the area).
- Tingling, numbness, and/or pain in affected area if the tumour is compressing a nerve.
- Eye bulging (if tumour is behind eye).
- Drooping of the eyelid (if tumour is behind the eye).
Not everyone with the symptoms above will have cancer, but see your general practitioner (GP) if you are concerned.
Diagnosis/diagnosing
If your doctor suspects you have a synovial sarcoma, they may order the following tests to confirm the diagnosisUsing medical test results, identify and name a disease and/or condition. and refer you to a specialist for treatment.
Physical examination
Your doctor will collect your overall medical history, as well as your current symptoms. Following this, they may examine your body to check for any abnormalities.
Imaging & blood tests
The doctor will take images of your body using magnetic resonance imagingTaking images/photos of inside body parts using magnet rather than x-ray. (MRITaking images/photos of inside body parts using magnet rather than x-ray.), a computed tomography scan (CT scanA 3-D (three dimensional) x-ray pictures that gives more information than a normal x-ray.), and/or positron emission tomography (PET scanA test that uses a radioactive drug to show a picture of how your tissues and organs are working. Also known as a positron emission tomography scan.), depending on where it is suspected the cancer is. The doctor may also look at other parts of the body and looks for signs of metastasis. Additionally, a bloodhello test may be taken to assessTo measure, look at and learn from. your overall health and help guide treatment decisions.
Biopsy
Once the location(s) of the cancer has been identified, the doctor will perform a biopsyTo take a small piece of body tissue and test it in a laboratory. to remove a section of tissue using a needle. The tissue sample will then be analysed for cancer cells. This can be done by a fine needle aspiration (FNA) or a core needle biopsy (CNB).