Best Doctor List Near You for Synovial Sarcoma in Veliko tarnovo

Synovial Sarcoma is a rare and aggressive type of soft tissue sarcoma primarily affecting the extremities, particularly around large joints such as the knee and ankle, but it can also occur in other locations, including the chest wall and abdomen. This tumor typically arises in young adults, commonly between the ages of 15 and 40, and shows a slight male predominance. Despite its name, synovial sarcoma does not necessarily originate from synovial tissue; it may arise in locations where synovial tissue is not present. Histologically, synovial sarcomas are characterized by a biphasic pattern, comprising both epithelial and mesenchymal components, which can complicate diagnosis. The epithelial component may present as sheets or nests of small, polygonal cells, while the mesenchymal component is typically spindle-shaped. A key diagnostic hallmark of synovial sarcoma is the presence of a specific chromosomal translocation, namely t(X;18)(p11;q11), which results in the fusion gene SS18-SSX. This genetic alteration is instrumental in the development of the tumor and serves as an important diagnostic marker. Due to its insidious onset, synovial sarcoma may be mistaken for benign lesions or other types of tumors, leading to delays in diagnosis. Patients commonly present with a palpable soft tissue mass, which may or may not be painful, and symptoms can include swelling and limited range of motion in nearby joints. Diagnostic evaluation typically involves imaging studies, such as magnetic resonance imaging (MRI) or computed tomography (CT), which help assess the size and extent of the tumor. A definitive diagnosis is made through a combination of imaging studies and biopsy, with immunohistochemical staining playing a key role in distinguishing synovial sarcoma from other sarcomas. Treatment generally involves a multimodal approach, starting with surgical resection aimed at achieving negative margins, which is critical due to the high rates of local recurrence. Adjuvant therapies may include radiation therapy and chemotherapy, especially in cases where the tumor is high-grade or has metastasized. Given the aggressive nature of this malignancy, prognosis can vary significantly based on factors such as tumor size, grade, the presence of metastasis at diagnosis, and adequacy of surgical margins. Early detection and treatment are essential for improving outcomes; however, even with aggressive management, some patients may experience disease recurrence or metastasis, necessitating ongoing surveillance and potential further interventions. Overall, synovial sarcoma represents a challenging subset of soft tissue tumors, requiring a high index of suspicion and a careful multidisciplinary approach to optimize treatment and enhance patient survival.