Synovial sarcoma usually develops in cells around joints and tendons.
Synovial sarcoma can occur anywhere throughout the body. But, it often occurs around joints in the arms and legs, such as the knee or elbow.
Synovial sarcoma is most commonly associated with teenagers and young adults. Synovial sarcoma affects both males and females equally.
Synovial sarcoma is thought to be caused when certain chromosomes (the parts within cells that contain DNA) are broken apart and put back together in the wrong way. Researchers are still trying to find out why this happens and whether this causes synovial sarcoma.
Signs and symptoms
Symptoms of synovial sarcoma can vary depending on the size and location of your tumour. You may experience all, some or none of these symptoms before you are diagnosed with synovial sarcoma:
- A lump or swelling in the soft tissue of the body under the skin, often around the joints in the arms or legs
- This lump is often slow-growing to begin and painful
Diagnosis
A specialist doctor will diagnose synovial sarcoma through a series of tests. These may include:
- Physical examination – looking at and feeling any lump
- A scan – taking pictures of the inside of the body using scans such as ultrasound, x-ray, CT, EUS, PET or MRI scans
- A biopsy – taking and testing a sample of the tumour. Using this biopsy, a doctor will look to see if the biopsy looks like synovial sarcoma and whether it contains the chromosome error
To read more about these scans and tests, click here.
Treatment
Surgery
- The first treatment method for synovial sarcoma is surgery. The surgeon will remove the tumour and will aim to take out an area of normal tissue too – this is known as “taking a margin”. This is to make sure that all of the cancer has been removed
- Synovial sarcoma mostly affects the arms and legs, and surgeons will do limb-sparing surgery so that the limb can continue to work well
- Although very rare, if the cancer has spread throughout the limb, then the surgeons may have to perform a partial or full amputation to stop the cancer
Radiotherapy
- This treatment uses high-energy radiation to destroy cancer cells
- It can be used either before or after surgery
- When used before surgery, radiotherapy aims to make the tumour smaller so that it can be more easily removed
- When used after surgery, radiotherapy aims to kill off any remaining cancer cells that have not been removed by surgery
Chemotherapy
- This treatment uses anti-cancer drugs to destroy cancer cells. It is sometimes used in patients that have a high risk of the cancer coming back or if it has spread to other parts of the body, also known as “metastasis”
Targeted and experimental therapies
In synovial sarcoma, researchers have been learning more about treatments known as “targeted therapies” and “immunotherapies”.
- Targeted therapy: a treatment that targets specific characteristics within cancer cells in order to stop them from growing and spreading
- Immunotherapy: a treatment that helps the person’s own immune system to fight and kill cancer cells
- Researchers have found that some targeted therapies and immunotherapies worked well in clinical trials of synovial sarcoma. But, more research and trials are needed before these treatments are approved
Clinical trials
For all sarcoma clinical trials based in the UK that are currently recruiting, you can check our Clinical Trials Hub.
After treatment
After treatment, you will have regular follow-up appointments for several years. You should receive a follow-up schedule from your sarcoma clinical nurse specialist. The follow-ups will usually include:
- A chance to discuss symptoms
- An examination to look for any signs of synovial sarcoma returning. This may include scans such as CT, ultrasound or MRI scans
- A chest x-ray to rule out any secondary cancers occurring in the lungs
Living with
Synovial sarcoma can reappear in the same area after the treatment of a previous tumour; this is called a “local recurrence”.
If the cancer does reappear, it is important to get treated as quickly as possible. This could involve further surgery and/or radiotherapy; your treatment will be assessed on an individual basis. It is useful to check for recurrences yourself through self-examination: your doctor or sarcoma clinical nurse specialist can tell you what to look for.
If you are worried about your cancer returning, please contact your doctor or nurse. They may decide to bring forward the date of your follow-up appointment to investigate your concerns.
What if my cancer spreads to another part of my body?
A recurrence of synovial sarcoma may be accompanied by cancer in other parts of the body. This is called “metastasis” or “secondary cancer”. Some people are diagnosed with sarcoma because their metastases have been discovered before their primary synovial sarcoma tumour. In synovial sarcoma patients, these secondary cancers may appear in the lungs, which is why a chest x-ray is taken at follow-up appointments.
Secondary cancers may also appear in the bone and lymph nodes. Treatment for secondary cancer may involve surgery, radiotherapy or other therapy as appropriate; your treatment will be assessed on an individual basis.
If you have any questions or if you need to talk to someone, our Support Line team are here for you.
More information –
A scientific review on the current and future management of synovial sarcoma
A scientific review on the current management of synovial sarcoma
