Intraarticular Synovial Sarcoma

McKinney, Christopher D.; Mills, Stacey E.; Fechner, Robert E.

doi:10.1097/00000478-199210000-00014

Cited by 46 publications

(19 citation statements)

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“…5,7e10 Very rarely, it may originate inside the joint. 11 Young adults (15e40 years) are the most common affected age group by this neoplasm and the median age at the time of presentation has reported to be 30e38 years. 5,8,9,12e15 The patients tend to present late owing to its clinically benign course and nonspecific symptomatology and for the same reason, even diagnosis may be delayed.…”

Section: Discussion and Treatmentmentioning

confidence: 99%

“A 40-year-old female with painless, slow growing prepatellar mass”

Arora

Batra

Rao

et al. 2014

Journal of Clinical Orthopaedics and Trauma

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Section: Discussion and Treatmentmentioning

confidence: 99%

“A 40-year-old female with painless, slow growing prepatellar mass”

Arora

Batra

Rao

et al. 2014

Journal of Clinical Orthopaedics and Trauma

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“…The radiologic differential diagnoses include calcified lesions of the knee: old hematomas, calcifying bursitis [ 16], tumoral and metastatic calcinosis, synovial sarcoma [17][18][19][20], primary synovial chondromatosis, and synovial chondrosarcomas. These last two entities are the most important for clinicopathologic differential diagnosis.…”

Section: Discussionmentioning

confidence: 99%

Intracapsular Chondroma of the Knee: An Unusual Neoplasm

Rodríguez‐Peralto

López-Barea²,

Gonzalez-Lopez³

1997

Int J Surg Pathol

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Intracapsular chondroma is a rare lesion that has been reported under different names on 23 occasions. We describe a 52-year-old woman with intracapsular chondroma that involved the left knee. Radiologically, the mass was multilobulated, calcified, and sharply circumscribed and was lying between the patella and the anterolateral surface of the tibia. The peculiar histologic pattern of the tumor was composed of hyaline cartilage nodules with enchondral ossification or calcification, in apparent transition with septa of connective and adipose tissue. The most common differential diagnoses for this tumor are primary synovial chondromatosis and chondrosarcoma. We emphasize a possible metaplastic origin of the chondromatous component due to some mechanical posttraumatic disturbance of the infrapatellar fat pad. To our knowledge, the present case is the second intracapsular chondroma to be described in the European literature. Int J Surg Pathol 5(1/2): [49][50][51][52][53][54] 1997

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“…Currently, 9 cases of intra-articular SS have been reported with specific MRI findings [25][26][27][28][29][30][31][32][33][34][35][36].…”

Section: Staging Treatment and Follow-upmentioning

confidence: 99%

“…Initially, these cases were mistaken for benign lesions on imaging studies and even on intraoperative frozen section analysis in Case 1. In fact, mistaking this sarcoma for a benign entity has happened with nearly every reported case of intra-articular SS in the current literature [11,[25][26][27][28][29][30][31][32][33][34]. The most recent case report from Freidman, et al in 2013, demonstrated failure to consider malignancy in a 26-year-old man with a 2.7 cm intra-articular knee mass that led to a misdiagnosis of PVNS and subsequent arthroscopic resection as in Case 2 presented here-in [11].…”

Section: Staging Treatment and Follow-upmentioning

confidence: 99%

Primary Intra-Articular Synovial Sarcoma of the Knee: A Report of Two Cases and Review of the Literature

E¹,

P²,

Heare³

et al. 2018

Int J Radiol Imaging Technol

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ond most common soft-tissue sarcoma in children and adolescents, after rhabdomyosarcoma [3].Approximately 80% of primary SS arise in the extremities, most commonly in the para-articular regions, the knee being the most common site. However, true intra-articular origin is extremely rare, accounting for less than 5% of cases [4][5][6][7]. From an oncological standpoint, SS is generally regarded as a high-grade sarcoma characterized by slow tumor growth, and a propensity to invade local structures. These tumors have a 30-60% incidence of metastases, which may sometimes develop more than 5 years after the initial diagnosis [8][9][10][11][12][13].Synovial sarcomas are often diagnosed after surgical excision of misdiagnosed benign lesions. Excision of these masses have shown to leave residual tumor in up to 82% of cases [14]. Low-risk synovial sarcomas in pediatric and adolescent patients treated with surgical excision alone show 72% -90% event-free survival at 5 years [15,16]. Intermediate and high risk tumors treated with surgery alone have a more variable 5-year survival between 36% -76%, which raises the need for adjuvant treatment [17]. Synovial sarcoma is relatively chemosensitive within the class of soft tissue sarcomas. A study of 313 cases of synovial sarcomas showed a 27.8% response to chemotherapy compared to 18.8% of other soft tissue sarcomas [18]. Ifosfamide and doxorubicin are the most efficacious chemotherapies for this tumor and have shown to result in 60% survival at 5 years in the absence of surgical excision. Chemotherapy combined with surgical excision and radiation therapy increases overall survival to 80-95% after 3 years [19,20]. AbstractCase: We highlight two cases of primary intra-articular lesions with imaging consistent with Pigmented Villonodular Synovitis (PVNS) and synovial chondromatosis. These benign neoplasms are typically treated with arthroscopic synovectomy. However fluid insufflation of the knee joint in the setting of intra-articular malignancies can dramatically change treatment options. Conclusion:Isolated intra-articular masses in the knee should have careful consideration of the differential diagnosis. These cases highlight the importance of adhering to diagnostic and treatment algorithms for the management of soft tissue masses to avoid potentially catastrophic complications. These cases support the consensus that arthroscopic excisional biopsy is not indicated as the primary procedure for an intra-articular soft tissue mass of unknown etiology.

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Intraarticular Synovial Sarcoma

Cited by 46 publications

References 0 publications

“A 40-year-old female with painless, slow growing prepatellar mass”

“A 40-year-old female with painless, slow growing prepatellar mass”

Intracapsular Chondroma of the Knee: An Unusual Neoplasm

Primary Intra-Articular Synovial Sarcoma of the Knee: A Report of Two Cases and Review of the Literature

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