If you or a loved one has been diagnosed with synovial sarcoma, you may have questions about the cancer itself or treatment options. Our team of sarcoma experts at the OSUCCC – James is leading the way to make advancements for synovial sarcoma from groundbreaking research to new treatment approaches. Home to central Ohio’s only Sarcoma Clinic, our team of dedicated multidisciplinary experts see and treat over 80 types of sarcomas, including synovial sarcoma.
What is synovial sarcoma?
Synovial sarcoma is an incredibly rare type of cancer that primarily occurs in adolescents and young adults under the age of 30. It is a soft tissue sarcoma that can occur within muscles, fat and ligaments. This sarcoma often affects the extremities (such as arms or legs) and can occur near a joint within adjacent muscles, fat or nerves but rarely involves the joint itself. This sarcoma grows slowly. Synovial sarcoma diagnoses make up less than 1% of all cancer diagnoses; less than one in 1 million people will be diagnosed with it in the United States.
What causes synovial sarcoma?
Currently, there is no exact known cause of synovial sarcoma.
Synovial sarcoma starts in the soft tissues when abnormal cells grow out of control and invade surrounding healthy soft tissues. Our cells contain instructions called DNA, which tell normal healthy cells how to grow and replicate. However, over time, those instructions can change through a process called mutation. When the cells mutate, a tumor can form.
However, there are some risk factors that could increase the likelihood of developing synovial sarcoma. Risk factors are anything that could increase your chance of developing a condition. For some conditions, like certain cancers, there are things you can and can’t influence.
When it comes to synovial sarcoma, the biggest risk factors include sex and genetics. Males assigned at birth tend to have synovial sarcoma at a higher rate than females.
Genetics can play a role as well. A specific gene, called the SS18 gene, can bond with one of several synovial cell sarcoma genes (SSX) to form what is called a translocation. This creates a protein unique to synovial cell sarcoma and is diagnosed in more than 90% of these tumors upon biopsy. This genetic change is not inherited.
Synovial sarcoma symptoms
Symptoms of synovial sarcoma may vary depending on the location of the tumor and its size. It’s important to note that just because you may have one or more of these symptoms doesn’t mean you have the disease.
Common symptoms of synovial sarcoma may include:
- A lump or bump that grows over time
- Pain, swelling or numbness around the lump or bump
Be sure to see your doctor if you notice any unusual symptoms.
How is synovial sarcoma diagnosed?
If your doctor suspects that you may have synovial sarcoma, they may order a series of diagnostic tests to determine a cause.
Some common diagnostic tests may include:
- Computer tomography (CT) scan
- Magnetic resonance imaging (MRI) scan
- Ultrasound
- X-ray
- Biopsy
An OSUCCC – James radiologist will read your imaging results and share them with your doctor. If a biopsy is performed, a specially trained pathologist will look at the cells and determine the exact tumor type.
Synovial sarcoma treatment
If a synovial sarcoma diagnosis is made, a team of multidisciplinary sarcoma specialists — including surgical oncologists, radiation oncologists and other specialists from the OSUCCC – James — will create a custom treatment plan for you. There are several treatments for synovial sarcomas. The team may recommend one or more methods for you.
Some of these treatments may include one or a combination of the following:
Surgery
Surgical options and techniques will depend on the size and location of the sarcoma. The goal for synovial sarcoma treatment is to remove all of the tumor if possible and minimize damage to the surrounding tissue and function of the affected area. Older surgical techniques might have required amputation, but that’s a rare occurrence with advancements in new surgical approaches. At the OSUCCC – James, our team of experts can use specialized techniques like targeted muscle reinnervation (TMR) for tumors that need nerves resected to remove the tumor.
Surgical oncologists will determine the specific surgical technique used for your case and if additional therapies are needed to treat the sarcoma. Some of those additional treatments may include radiation or chemotherapy to help shrink a tumor before surgery as well.
Radiation therapy
Radiation therapy may be ordered to ensure all the cancer cells are removed. Radiation uses high-energy X-rays to kill the cancer cells in a highly targeted area. If radiation is ordered prior to surgery, it can help shrink a tumor to make synovial sarcoma surgery more successful. If radiation is ordered after surgery, it can ensure that any remaining cancerous cells are treated.
Chemotherapy
In some cases, synovial sarcoma may be treated with chemotherapy to reduce tumor size prior to surgery, if it has spread or if the surgery cannot remove all of the cancer. The type of chemotherapy used for the synovial sarcoma treatment along with any other supportive therapies will be chosen by your OSUCCC – James specialist.
Targeted therapies
Some targeted therapies may be used in treatment approaches for synovial sarcoma. Targeted therapies work on sarcomas by attacking specific cells found within the cancer. The specific type will be determined by your doctors.
Additional Resources
Types of Sarcoma
Soft Tissue Sarcoma
Gynecologic Sarcoma
Screening and Diagnosis
Clinical Trials