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Synovial Sarcoma

Translocation-Associated High-Grade Sarcoma of Adolescents and Young Adults

Written by: Saygı Hospital Health Guide Editorial Board
Last updated:

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

References (5)

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Onkoloji department. Book Appointment →

What is Synovial Sarcoma?

Synovial sarcoma is a translocation-driven mesenchymal tumor defined by chromosomal translocation t(X;18)(p11;q11) producing SS18-SSX1, SS18-SSX2, or rarely SS18-SSX4 fusion proteins.

Despite its name, it does not arise from synovium — instead occurring in deep soft tissues near major joints (knee, ankle, hip, shoulder), but also in non-articular sites such as head/neck, trunk, and viscera.

Histologic patterns include biphasic (epithelial and spindle cell), monophasic spindle cell, and poorly differentiated forms — all sharing the diagnostic translocation.

Symptoms

Slow-growing, deep, palpable mass — often present for months to years before diagnosis
Pain, especially with activity (paraarticular location)
Common locations: thigh, knee, calf, foot, but can occur anywhere
Limited range of motion or nerve compression symptoms
Pulmonary metastases at presentation in 25-30%
Lymph node involvement uncommon (under 5%)
Older lesions may calcify, visible on imaging

Risk Factors

Adolescents and young adults (median age 30-35)
Slight male predominance
No known hereditary predisposition
Prior radiation therapy (rare association)
No clear environmental causes
Translocation appears to be a sporadic event in mesenchymal stem cells

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • Persistent deep mass in extremity, especially in young adult
  • Pain near joint not explained by injury or inflammation
  • Mass present for months — biopsy required for any deep soft tissue lesion over 5 cm
  • Pulmonary symptoms or imaging findings in patient with extremity mass
  • Recurrent extremity 'lipoma' or 'cyst' that grows or causes symptoms

Treatment Methods

01
Wide surgical resection with negative margins — primary curative treatment
02
Limb-sparing surgery preferred when feasible
03
Adjuvant radiation therapy for high-grade tumors or marginal resections
04
Adjuvant chemotherapy controversial; doxorubicin/ifosfamide considered for high-risk disease (size over 5 cm, deep, high grade)
05
First-line systemic for metastatic: doxorubicin ± ifosfamide
06
Pazopanib for advanced disease after chemotherapy
07
Trabectedin demonstrates activity in synovial sarcoma
08
Afamitresgene autoleucel (TCR-T cell therapy targeting MAGE-A4) — FDA-approved 2024 for HLA-A*02 positive metastatic disease
09
Multidisciplinary sarcoma center management improves outcomes
10
Long-term surveillance with chest CT — late metastases possible

Which Department to Visit?

You can visit our Onkoloji department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.