Synovial Sarcoma: Frequency of Nonaggressive MR Characteristics

Blacksin, Marcia F.; Siegel, Jill R.; Benevenia, Joseph; Aisner, Seena C.

doi:10.1097/00004728-199709000-00025

Cited by 87 publications

(46 citation statements)

References 8 publications

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“…14b, c). Small tumors, less than 5 cm, present a more homogenous intensity signal [50] and may be confused with benign lesions, especially if their margins are well defined [49,50]. Synovial sarcoma shows intense but heterogeneous gadolinium enhancement (Fig.…”

Section: Synovial Sarcomamentioning

confidence: 99%

See 1 more Smart Citation

MR imaging of synovial tumors and tumor-like lesions

Narváez¹,

Narváez

Aguilera³

et al. 2001

Eur Radiol

137

104

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The clinical diagnosis of synovial tumors and tumorlike lesions is difficult, and radiographic findings may establish a confident diagnosis only in some cases. MR imaging has become the modality of choice in evaluating these lesions, because with it a presumptive diagnosis can be made in most cases. Our goal is to review the MR features of pigmented villonodular synovitis, giant-cell tumor of the tendon sheath, synovial chondromatosis, synovial hemangioma, lipoma arborescens, synovial cysts and synovial sarcoma, emphasizing those findings that suggest a specific diagnosis.

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Section: Synovial Sarcomamentioning

confidence: 99%

“…Synovial sarcoma shows intense but heterogeneous gadolinium enhancement (Fig. 15b), which may help to differentiate these small homogeneous tumors from benign cystic lesions [50].…”

Section: Synovial Sarcomamentioning

confidence: 99%

MR imaging of synovial tumors and tumor-like lesions

Narváez¹,

Narváez

Aguilera³

et al. 2001

Eur Radiol

137

104

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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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“…Synovial sarcoma, when small, is often mistaken for a ganglion cyst or bursitis due to its homogeneous high signal on T2-W imaging, smooth, rounded appearance, and position near the joint [ 74 ]. It is the malignant lesion most likely to be misdiagnosed as benign [ 5 ].…”

Section: Imagingmentioning

confidence: 99%

Soft Tissue Masses

Roper

Stein-Wexler

2014

Pediatric Orthopedic Imaging

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The chapter is divided in two parts: the fi rst part discusses benign masses and the second addresses malignancies. Vascular lesions are discussed, differentiating between high-fl ow and low-fl ow lesions. Fatty lesions, neurofibromas, tumoral calcinosis, and myositis ossifi cans are described in detail, and hematomas, popliteal cysts, and other lesions are presented more briefl y. The following section on malignant masses focuses on sarcomas and other fi brous tumors. The discussion of sarcomas includes infantile fi brosarcoma, synovial sarcoma, rhabdomyosarcoma, lymphoma/leukemia, as well as lesions such as epithelioid sarcoma, granulocytic sarcoma, liposarcoma, extraskeletal Ewing sarcoma/osteosarcoma, and hemangiopericytoma.

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Synovial Sarcoma: Frequency of Nonaggressive MR Characteristics

Cited by 87 publications

References 8 publications

MR imaging of synovial tumors and tumor-like lesions

MR imaging of synovial tumors and tumor-like lesions

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

Soft Tissue Masses

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