Associated symptoms
The symptoms of synovial sarcoma are relatively unspecific. Usually, pain in the immediate vicinity of the synovial sarcoma is known, but its character cannot be described in detail. In addition, there is a pressure pain at the corresponding site and pain dependent on movement.
In addition, a restriction of movement is sometimes described in this context. In addition to the pain, swelling is considered a symptom of synovial sarcoma. The swelling is based on the nodular growth of the tumor in the depth and is characteristically progressive, i.e. progressive with worsening of the symptoms.
Since the synovial sarcoma is a malignant disease, the classic B-symptoms also occur after a certain level of illness: a triad of fever, night sweats and weight loss. However, this is rather rare. In general, at the onset of synovial sarcoma, there is often no causal relationship between the symptoms and a possible synovial sarcoma, since at this time there are no abnormalities in imaging that would confirm the diagnosis of a synovial sarcoma. In general, the symptoms of synovial sarcoma are rather insidious.
Diagnosis
Since this is a malignant disease, an aggressive approach is necessary. Conservative measures are not effective in the treatment of synovial sarcoma. The therapy of choice is considered to be extensive resection, i.e. removal of the synovial sarcoma.
The tumor itself, its pseudocapsule and all other tissue already infiltrated by the synovial sarcoma must be removed. The goal is to remove the synovial sarcoma completely (i.e. R0 = complete resection). However, since the tumor often develops in the extremities, R0 resection may require amputation.
In order to avoid amputation of the extremity, only a partial resection can be attempted (i.e. R1 = partial resection). After the resection, the therapy plan includes radiation therapy as standard, since there is a high probability that the tumor will return, i.e. that a relapse will occur. Before surgery, radiation is only performed if the synovial sarcoma is located in a deep and difficult to reach part of the body.
The synovial sarcoma is sensitive to chemotherapy, but not in every case. Usually, chemotherapeutic agents such as cisplatin, VIncristine, Adriamycin and Doxorubicin are used. The effectiveness and exact value of chemotherapy is currently not yet clear. Chemotherapy is indicated as soon as distant metastases are present, the tumor could not be completely removed after resection, or a certain aggressive subtype is involved.
