Synovial sarcoma
Synovial sarcoma
Updated: 08/07/2020
© Jun Wang, MD, PhD
General features
- Biphasic malignant tumor with both epithelial and mesenchymal components
- May be monophasic
- More common in young adults, male
Clinical presentations
- Mass near large joint
- Most common sites: Knee and ankle
- Joint rarely involved
Key morphological features
- Epithelial cells lining duct-like spaces
- Hyperchromic spindle cells in the background
- Monophasic: Only spindle cell components, that are positive for EMA
Markers
- Positive for EMA and cytokeratin in both components
- Vimentin in spindle cells
Genetic abnormalities
- t(X;18)(p11.1;q11): SYT-SSX1 fusion
- t(X;18)(p11.21;q11): SYT-SSX2 fusion genes
Treatment
- Excision
- Radiation
Poor prognosis indicators
- High grade, high proliferative index
- Necrosis
- SYT-SSX1 fusion
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