Synovial Sarcoma

What is synovial sarcoma?

Synovial sarcoma is a kind of soft tissue sarcoma, which is a type of cancer that arises from soft tissues near the joints but can sometimes develop in the kidney and lung.

Despite its name and its location near the joints, synovial sarcoma does not arise from actual synovial tissue (the tissue that forms the joint’s lining). Researchers do not known what kinds of cells develop into this cancer.

Synovial sarcoma is a very rare tumor and is seen more often in young people, usually younger than 30. Synovial sarcoma has no known risk factors, but genetics may play a role in its growth.

How common is synovial sarcoma?

Soft tissue sarcomas are rare. They represent less than 1% of all malignant tumors. Synovial sarcoma is even more uncommon. It occurs in only 1 to 3 people per million. About 800 new cases of synovial sarcoma are diagnosed in the U.S. each year. 

Synovial sarcoma is somewhat more common in males. It occurs in about 12 males for every 10 females with the cancer. 

What are the signs and symptoms of synovial sarcoma?

A synovial sarcoma tumor often grows slowly and may not be noticed for a long time before causing signs and symptoms.

When signs and symptoms do occur, they appear near the affected area, usually in the hands, lower leg or feet. These may include the following:

• A mass or swelling near the affected area, often painless
• Problems using one or both legs, feet, arms or hands
• Pain near the affected area, if the tumor invades an area with a lot of nerves
• Problems with bodily functions near the affected area, such as breathing problems if the tumor is near the neck

How is synovial sarcoma treated?

Removing the tumor by surgery is the preferred treatment for synovial sarcoma because this makes the cancer easier to treat. Once the mass is removed, a small amount of normal surrounding tissue is also removed to gain the best odds of getting all cancerous (malignant) cells.

Depending on the size and how aggressive the tumor is under the microscope, surgery can be combined with one or both of these treatments:

• Chemotherapy (“chemo”)—uses powerful medicines to kill cancer cells or stop them from growing (dividing) and making more cancer cells:
  • Chemo may be injected into the bloodstream, so that it can travel throughout the body.
  • Some chemo may be given by mouth.
  • Combination therapy uses more than one type of chemo at a time.

Chemo may be used before surgery to shrink the tumor or after surgery to remove any cancer cells left behind. It might also be used on its own to treat synovial sarcoma that has spread or is hard to reach by surgery.

• Radiation therapy—uses high-energy X-rays or other types of radiation to kill cancer cells or stop them from growing. This treatment may be used before surgery to shrink the tumor or after surgery to remove any cancer cells left behind.

What are the survival rates for synovial sarcoma?

The prognosis for people with synovial sarcoma has improved during the past two decades because of treatment advances involving surgery, chemotherapy and radiation.

The factors for prognosis include the following: 

• Small tumor size—less than 5cm wide
• A tumor whose cells are dividing under the microscope
• A tumor that is easy to remove by surgery
• A localized tumor—one that has not spread (metastasized)
• A person of younger age

The overall five-year survival rate for synovial sarcoma is 36% to 76%. But, each person’s experience is unique and results are hard to predict. The survival rate for synovial sarcoma is lower in cases where the cancer has returned or spread.

Why choose St. Jude for your child’s synovial sarcoma treatment?

• St. Jude is the only National Cancer Institute-designated Comprehensive Cancer Center devoted solely to children.
• St. Jude has created more clinical trials for cancer than any other children’s hospital in the United States.
• The nurse-to-patient ratio at St. Jude is unmatched—averaging 1:3 in hematology and oncology, and 1:1 in the Intensive Care Unit.
• St. Jude is committed to not only finding cures, but also helping children hold on to their quality of life. Children are not just small people. Their bodies and systems are unique, along with the disorders that affect them. For the best care, they need a specialized team. That is what you get at St. Jude.
• Our doctors work closely with support staff in nursing, rehabilitation services, pharmacy, clinical nutrition, child life and social work, along with many others. These support staff have been specially trained to care for children with cancer.
• St. Jude practices patient family-centered care. Patient family-centered care is health care that focuses on the family as a child’s primary source of strength, support and well-being. At the heart of patient family-centered care is the belief that health care staff and the family are partners, working together to best meet the needs of the child. Excellence in health care happens when we work together and honor the expertise each of us brings to every health care encounter.
• New radiation treatments such as intensity-modulated radiation therapy (IMRT) and proton beam radiation therapy may be used to decrease the side effects of treatment.
• St. Jude has a specialized team of experts who perform limb-salvage procedures (surgery) in children with synovial sarcoma.