Paul H Hartel1,2* and John E Parker2
1Consultant Histopathologist, Sligo University Hospital, Ireland 2Department of Medicine, West Virginia University, School of Medicine, USAFulltext PDF
Radiologic imaging is an important tool in diagnosis, staging and management of synovial sarcoma. Soft tissue synovial sarcoma has some characteristic findings on imaging studies, i.e., high vascularity, tumour calcification and intermuscular growth. We compared known imaging characteristics of soft tissue synovial sarcoma with those of a set of primary thoracic synovial sarcomas to add to the literature of this rare sarcoma. 61 cases diagnosed as primary thoracic synovial sarcoma, from 1981 to 2020, were retrieved from tissue archives. Chest radiographs, computed tomography, magnetic resonance imaging, or positron emission tomography/computed tomography studies were available and reviewed in 14 cases. Radiologically, compared with soft tissue synovial sarcoma, primary thoracic synovial sarcoma shows less vascularity in general, no cortical bone destruction, no tumour calcification or HPC-like vasculature and no invasion into chest wall or intermuscular growth. Additionally, in contrast to soft tissue synovial sarcoma, lymphadenopathy suggestive of metastasis was not seen. Lack of PET-avidity of suspicious lesions should not discourage close clinical followup. Awareness of the lack of classic soft tissue synovial sarcoma imaging findings will aid radiologic diagnosis of primary thoracic synovial sarcoma.
Hartel PH, Parker JE. Radiologic Findings in Primary Thoracic Synovial Sarcoma Differ from Soft Tissue Synovial Sarcoma. Ann Clin Radiol. 2021; 4(1):1017.