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Joseph Junewick, MD FACR
over 7 years ago
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ARSt Case Repository

Synovial Sarcoma

Case Detail

Anatomy: Musculoskeletal
Junewick
Joseph Junewick, MD FACR
Diagnostic Category: Neoplasia Malignant
Created: over 5 years ago
Updated: over 5 years ago
Tags: PEDS
Modality/Study Types: MR
Activities:
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History

Child with painful forearm mass.


Case Images


Diagnosis

Synovial Sarcoma

Findings

US – Solid, hypervascular ovoid mass.

MR – Encapsulated mildly heterogeneous soft tissue mass in the anterior proximal forearm demonstrating hyperintensity on T1, T2 and post-gadolinium sequences.

Discussion

Synovial sarcoma is the fourth most common type of soft-tissue sarcoma and accounts for 2.5%-10.5% of all primary soft-tissue malignancies. The majority, 80% – 95%, occur in the extremities. Approximately two-thirds occur in the lower extremity and one-fourth in the upper extremity. Synovial sarcoma is typically seen in the popliteal fossa of adolescents and young adults. Despite its name, the lesion usually occurs near but not in a joint. It is an intermediate to high-grade neoplasm with extensive metastatic potential. Radiographic findings of a soft-tissue mass near a joint in a young patient with calcification are very suggestive of synovial sarcoma. Cross-sectional imaging appearances include multilobulated morphology and marked heterogeneity with hemorrhage, fluid levels, and septa.

Reference

Murphey MD, Gibson MS, Jennings BT, et al. Imaging of Synovial Sarcoma with Radiologic-Pathologic Correlation. Radiographics (2008); 26: 1543-1565.

Contributor

Rekha Meesa, MD



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