Synovial sarcoma: the misdiagnosed sarcoma

Abstract

Synovial sarcoma is a rare and highly malignant soft tissue sarcoma. The inconspicuous and diversity of its early symptoms make it a highly misdiagnosed disease. The management of synovial sarcomas is challenging as they are rare and have a poor prognosis. Early and correct diagnosis and treatment are critical for clinical outcomes. Misdiagnosis or delayed diagnosis can have devastating consequences for the patient. The detection of SS18 gene rearrangement is considered a powerful tool in establishing the diagnosis of synovial sarcomas. Biopsies and testing for gene rearrangements are recommended for all patients in whom SS cannot be excluded. Surgery is the mainstay of treatment for synovial sarcomas. Neoadjuvant/adjuvant radiotherapy is recommended for patients with big tumors (>5 cm) or positive resection margins, and neoadjuvant/adjuvant chemotherapy is recommended for patients with high-risk tumors or advanced diseases. This article reviews synovial sarcomas from the perspectives of clinical and radiological presentation, histological and cytogenetic analysis, differential diagnosis, treatment, and prognosis.

Combination of HDAC and FYN inhibitors in synovial sarcoma treatment

“…The most common places that the tumors can be found are in the ankles or knees; however, metastases occur in approximately 50% of synovial sarcoma patients and have been documented to grow at distinct sites, such as the brain, liver, lung and lymph nodes ( Krieg et al, 2011 ; Vlenterie et al, 2016 ). Although pain manifests around the affected areas, synovial sarcoma can be often misdiagnosed as arthritis or bursitis since the pain envelopes around the joints with no obvious changes of surrounding tissue unless checked with x-rays ( Li et al, 2024 ). The standard treatment for synovial sarcoma, similar to other cancers, is surgery in conjunction with radiation and/or chemotherapy ( Blay et al, 2023 ).…”