Skip to main content

Advertisement

SpringerLink
Log in

Underlying synovial sarcoma undiagnosed for more than 20 years in a patient with regional pain: a case report

  • Case Report
  • Published:
Skeletal Radiology Aims and scope Submit manuscript

Abstract

Synovial sarcoma (SS) is a malignant tumor comprising 5–10% of all soft tissue sarcomas. SS has distinct characteristics, such as a predilection for young adults and relatively slow growth compared to other soft tissue sarcomas. Some patients with SS experience long-standing pain at the tumor site before the development of a palpable mass. Herein, we report the case of a 39-year-old woman with SS in the upper arm who presented with pain for > 20 years. The tumor detected on magnetic resonance imaging at 17 years was an SS. To the best of our knowledge, no English-language reports on imaging study-based identification of SS, which was undiagnosed for > 20 years, are known in the literature. This report discusses the imaging features of this latent lesion and the volume-doubling time of this unusual tumor.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6
Fig. 7

Similar content being viewed by others

References 

  1. Murphey MD, Gibson MS, Jennings BT, Crespo-Rodríguez AM, Fanburg-Smith J, Gajewski DA. From the archives of the AFIP: Imaging of synovial sarcoma with radiologic-pathologic correlation. Radiographics. 2006;26:1543–65.

    Article  PubMed  Google Scholar 

  2. Suurmeijer AJH, Ladanyi M, Nielsen TO. Synovial sarcoma. In: WHO Classification of Tumours of Soft Tissue and Bone, 5th Ed. WHO Classification of Tumours Editorial Board. International Agency for Research on Cancer, Lyon, France, p.290–3, 2020.

  3. Gazendam AM, Popovic S, Munir S, Parasu N, Wilson D, Ghert M. Synovial sarcoma: a clinical review. Curr Oncol. 2021;28:1909–20.

    Article  PubMed  PubMed Central  Google Scholar 

  4. De Silva MV, Barrett A, Reid R. Premonitory pain preceding swelling: a distinctive clinical presentation of synovial sarcoma which may prompt early detection. Sarcoma. 2003;7:131–5.

    Article  PubMed  PubMed Central  Google Scholar 

  5. Imaizumi S, Morita T, Kobayashi H, Ito T, Hirata Y. Synovial sarcoma with extended occult period treated as juvenile rheumatoid arthritis: a case report. J Orthop Sci. 2002;7:570–3.

    Article  PubMed  Google Scholar 

  6. Chotel F, Unnithan A, Chandrasekar CR, Parot R, Jeys L, Grimer RJ. Variability in the presentation of synovial sarcoma in children: a plea for greater awareness. J Bone Joint Surg Br. 2008;90:1090–6.

    Article  CAS  PubMed  Google Scholar 

  7. Wright PH, Sim FH, Soule EH, Taylor WF. Synovial sarcoma. J Bone Joint Surg Am. 1982;64:112–22.

    Article  CAS  PubMed  Google Scholar 

  8. Kennedy R, Hester J, Simon DW. Malignancy as a possible complication of complex regional pain syndrome: a case report. Pain Med. 2010;11:101–5.

    Article  PubMed  Google Scholar 

  9. Schwartz M. A biomathematical approach to clinical tumor growth. Cancer. 1961;14:1272–94.

    Article  CAS  PubMed  Google Scholar 

  10. Choi ES, Han I, Cho HS, Kang HG, Kim JH, Kim HS. Distinct clinical characteristics of unplanned excision in synovial sarcoma. Clin Orthop Surg. 2015;7:254–60.

    Article  PubMed  PubMed Central  Google Scholar 

  11. Baranov E, McBride MJ, Bellizzi AM, Ligon AH, Fletcher CDM, Kadoch C, et al. A novel SS18-SSX fusion-specific antibody for the diagnosis of synovial sarcoma. Am J Surg Pathol. 2020;44:922–33.

    Article  PubMed  PubMed Central  Google Scholar 

  12. Amary MF, Berisha F, Bernardi Fdel C, Herbert A, James M, Reis-Filho JS, et al. Detection of SS18-SSX fusion transcripts in formalin-fixed paraffin-embedded neoplasms: analysis of conventional RT-PCR, qRT-PCR, and dual color FISH as diagnostic tools for synovial sarcoma. Mod Pathol. 2007;20:482–96.

    Article  CAS  PubMed  Google Scholar 

  13. Jones BC, Sundaram M, Kransdorf MJ. Synovial sarcoma: MR imaging findings in 34 patients. Am J Roentgenol. 1993;161:827–30.

    Article  CAS  Google Scholar 

  14. Fiore M, Sambri A, Spinnato P, Zucchini R, Giannini C, Caldari E, et al. The biology of synovial sarcoma: state-of-the-art and future perspectives. Curr Treat Options Oncol. 2021;22:109.

    Article  PubMed  PubMed Central  Google Scholar 

  15. Sedaghat M, Sedaghat S. Primary synovial sarcoma on MRI - a case series and review of the literature. Pol J Radiol. 2023;88:e325–30.

    Article  PubMed  PubMed Central  Google Scholar 

  16. Tordjman M, Honoré C, Crombé A, Bouhamama A, Feydy A, Dercle L, et al. Prognostic factors of the synovial sarcoma of the extremities: imaging does matter. Eur Radiol. 2023;33:1162–73.

    Article  PubMed  Google Scholar 

  17. Blacksin MF, Siegel JR, Benevenia J, Aisner SC. Synovial sarcoma: frequency of nonaggressive MR characteristics. J Comput Assist Tomogr. 1997;21:785–9.

    Article  CAS  PubMed  Google Scholar 

  18. Freire V, Moser TP, Lepage-Saucier M. Radiological identification and analysis of soft tissue musculoskeletal calcifications. Insights Imaging. 2018;9:477–92.

    Article  PubMed  PubMed Central  Google Scholar 

  19. Goldblum JR, Folpe AL, Weiss SW. Synovial sarcoma. Enzinger and Weiss’s Soft Tissue Tumors. 7th edn. Philadelphia: Elsevier; 2020.

  20. WHO Classification of Tumours Editorial Board (2020) Soft Tissue and Bone Tumours. In: WHO Classification of Tumours series, 5th edn, vol 3. International Agency fo Research on Cancer, Lyon. https://publications.iarc.fr/588

  21. Friberg S, Mattson S. On the growth rates of human malignant tumors: implications for medical decision making. J Surg Oncol. 1997;65:284–97.

    Article  CAS  PubMed  Google Scholar 

  22. Ogose A, Kawashima H, Ariizumi T, Hotta T, Oike N, Yamagishi T, et al. Natural history of sarcomas: is sarcoma congenital disease? J Jpn Orthop Assoc. 2017;91:417–22.

    Google Scholar 

  23. Spratt JS. The rate of growth of skeletal sarcomas. Cancer. 1965;18:14–24.

    Article  Google Scholar 

  24. Koizumi S, Kida M, Yamauchi H, Okuwaki K, Iwai T, Miyazawa S, et al. Clinical implications of doubling time of gastrointestinal submucosal tumors. World J Gastroenterol. 2016;22:10015–23.

    Article  PubMed  PubMed Central  Google Scholar 

  25. Lillington GA. Management of solitary pulmonary nodules. Dis Mon. 1991;37:271–318.

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Orthopedic Oncology, Niigata Cancer Center Hospital, 2-15-3, Kawagishi-Cho, Chuo-Ku, Niigata, Niigata, 951-8556, Japan

    Hiroshi Hatano, Tetsuro Yamagishi & Kazuhito Yanabashi

  2. Department of Orthopedic Surgery, Uonuma Institute of Community Medicine, Niigata University Medical and Dental Hospital, 4132, Urasa, Minamiuonuma, Niigata, 949-7302, Japan

    Akira Ogose

Authors
  1. Hiroshi Hatano
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Tetsuro Yamagishi
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Kazuhito Yanabashi
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Akira Ogose
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Hiroshi Hatano.

Ethics declarations

Ethical approval

All procedures involving human participants in this study followed the ethical standards of the institutional and/or national research committee, the 1964 Helsinki Declaration and its later amendments, or comparable ethical standards. Informed consent was obtained from all the subjects described in this study.

Conflict of interest

The authors declare no competing interests.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Hatano, H., Yamagishi, T., Yanabashi, K. et al. Underlying synovial sarcoma undiagnosed for more than 20 years in a patient with regional pain: a case report. Skeletal Radiol (2024). https://doi.org/10.1007/s00256-024-04701-8

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • DOI: https://doi.org/10.1007/s00256-024-04701-8

Keywords

Search

Navigation