Primary synovial sarcoma on MRI – a case series and review 
of the literature

Sedaghat, Maya; Sedaghat, Sam

doi:10.5114/pjr.2023.130048

Cited by 6 publications

(3 citation statements)

References 36 publications

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“…Sedaghat et al. 11 performed MRI in 15 histologically-confirmed primary SS cases, revealing that 60% of the tumors displayed the triple sign. Liang et al.…”

Section: Discussionmentioning

confidence: 99%

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Synovial sarcoma of the viscera (lung and jejunum): a case report

He,

Wang,

Yang

et al. 2024

J Int Med Res

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We report the case of a woman nearing 70 years old who was admitted to the hospital with a complaint of “epigastric distension for 1 month”. Her main signs and symptoms were progressive abdominal distension and occasional abdominal pain. Computed tomography suggested an abdominal mass. She had a surgical history of synovial sarcoma (SS) of the lungs. After admission, she was diagnosed with jejunal SS following a puncture biopsy and laparoscopic surgery. This disease usually occurs in the soft tissues of the limbs, and it is extremely rare for SS to originate in the jejunum. The morphologic heterogeneity of SS overlaps with other tumors and makes the diagnosis particularly difficult. Imaging studies usually lack specificity; however, measuring multiple immunohistochemical markers can greatly assist in the diagnosis and differential diagnosis of SS. This case not only enriches our understanding of SS and describes a rare site of origin, but also emphasizes the importance and challenges of achieving an accurate diagnosis. Immunohistochemical and molecular biological testing have important roles in the definitive diagnosis, highlighting the need for precise and innovative diagnostic and therapeutic approaches in SS.

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“…Sedaghat et al. 11 performed MRI in 15 histologically-confirmed primary SS cases, revealing that 60% of the tumors displayed the triple sign. Liang et al.…”

Section: Discussionmentioning

confidence: 99%

“…10 However, not all SSs exhibit the typical "triple sign". Sedaghat et al 11 performed MRI in 15 histologicallyconfirmed primary SS cases, revealing that 60% of the tumors displayed the triple sign. Liang et al 9 identified the triple sign in only 50% of their cases, while Ashikyan et al 12 noted its presence in 80% of SSs.…”

Section: Case Presentationmentioning

confidence: 99%

Synovial sarcoma of the viscera (lung and jejunum): a case report

He,

Wang,

Yang

et al. 2024

J Int Med Res

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“…However, around one-third of larger lesions exhibit distinctive features of heterogeneity on T2weighted images, including the ''bowl of grapes'' appearance, indicating a multicystic mass with varying fluid intensities and "fluid-fluid levels", as well as the ''triple sign,'' signifying areas of hyperintensity, isointensity, and hypointensity relative to skeletal muscle [17]. The "bowl of grapes" appearance may arise due to the presence of hyperintense areas on fluid-sensitive sequences with interspersed T2 hypointense septa (Figure 6) [38][39][40]. This finding is not unique to synovial sarcoma and is also seen in undifferentiated pleomorphic sarcoma [41].…”

Section: Magnetic Resonance Imaging (Mri)mentioning

confidence: 99%

Synovial Sarcoma in the Extremity: Diversity of Imaging Features for Diagnosis and Prognosis

Cho,

Lee,

Kim

et al. 2023

Cancers

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Synovial sarcomas are rare and highly aggressive soft-tissue sarcomas, primarily affecting adolescents and young adults aged 15–40 years. These tumors typically arise in the deep soft tissues, often near the large joints of the extremities. While the radiological features of these tumors are not definitely indicative, the presence of calcification in a soft-tissue mass (occurring in 30% of cases), adjacent to a joint, strongly suggests the diagnosis. Cross-sectional imaging characteristics play a crucial role in diagnosing synovial sarcomas. They often reveal significant characteristics such as multilobulation and pronounced heterogeneity (forming the “triple sign”), in addition to features like hemorrhage and fluid–fluid levels with septa (resulting in the “bowl of grapes” appearance). Nevertheless, the existence of non-aggressive features, such as gradual growth (with an average time to diagnosis of 2–4 years) and small size (initially measuring < 5 cm) with well-defined margins, can lead to an initial misclassification as a benign lesion. Larger size, older age, and higher tumor grade have been established as adverse predictive indicators for both local disease recurrence and the occurrence of metastasis. Recently, the prognostic importance of CT and MRI characteristics for synovial sarcomas was elucidated. These include factors like the absence of calcification, the presence of cystic components, hemorrhage, the bowl of grape sign, the triple sign, and intercompartmental extension. Wide surgical excision remains the established approach for definitive treatment. Gaining insight into and identifying the diverse range of presentations of synovial sarcomas, which correlate with the prognosis, might be helpful in achieving the optimal patient management.

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