Synovial Sarcoma: Epidemiology, Prognosis, and Imaging in a Tertiary Referral Centre

Abstract

Objectives: To review the disease pattern of synovial sarcoma in a tertiary sarcoma centre in Hong Kong. Methods: Patients with a histological diagnosis of synovial sarcoma from June 2000 to June 2014 were recruited. Patient data were collected using the electronic Patient Record System and available images were reviewed using the Picture Archiving and Communication System. Kaplan-Meier analysis was performed for overall survival. Multivariate Cox regression was performed to evaluate potential prognostic factors. Results: A total of 45 consecutive patients with a mean age of 39 years and male-to-female ratio of 1:1.05 were recruited. Tumours were evident in the lower extremities in 28 (62%) cases, in the upper extremities in four (9%), and elsewhere in 13 (29%). The mean duration of symptoms to diagnosis was 1.5 years. The mean tumour size was 7.0 cm. Metastatic disease was present in 11 (24%) patients at initial diagnosis. The most common site of metastasis was the lung. Nineteen patients died of synovial sarcoma during follow-up. The median survival time was 7.5 years. Tumour size of >5 cm (hazard ratio [HR] = 10.06; 95% confidence interval [CI], 1.30-78.15; p = 0.027) and presence of metastasis at diagnosis (HR = 5.56; 95% CI, 1.20-25.77; p = 0.028) were significant adverse prognostic factors after adjustment for age, gender, tumour location, histological subtypes, and adjuvant therapy. Conclusion: Tumour size of >5 cm and presence of metastasis at diagnosis were identified as adverse prognostic factors.

The Potential of Immersive Virtual Reality for Cognitive Training in Elderly

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Gastric pull‐up with laryngeal preservation of the primary synovial sarcoma of the esophagus: A case report

“…The tumor is commonly hypointense to muscles and heterogeneous on T1-and T2weighted images, respectively. 1 The T2-weighted MRI images may demonstrate the "triple sign" due to the presence of areas with low, medium, and high signal intensities. 6 Histologically, they are classified into three types: monophasic, biphasic, and poorly differentiated.…”

“…However, MRI is the imaging modality of choice to stage the tumor locally. The tumor is commonly hypointense to muscles and heterogeneous on T1‐ and T2‐weighted images, respectively 1 . The T2‐weighted MRI images may demonstrate the "triple sign" due to the presence of areas with low, medium, and high signal intensities 6 .…”

“…A synovial sarcoma is a soft tissue sarcoma subtype, which is assumed to arise from mesenchymal cells. 1 The name is derived from its microscopic resemblance to the synovium under light microscopy. Synovial sarcoma accounts for approximately 5%-10% of all soft tissue sarcomas.…”