Synovial sarcoma is the fourth most common type of soft-tissue sarcoma, accounting for 2.5%–10.5% of all primary soft-tissue malignancies worldwide. Synovial sarcoma most often affects the extremities (80%–95% of cases), particularly the knee in the popliteal fossa, of adolescents and young adults (15–40 years of age). Despite its name, the lesion does not commonly arise in an intraarticular location but usually occurs near joints. Histologic subtypes include monophasic, biphasic, and poorly differentiated; the cytogenetic aberration of the t(X;18) translocation is highly specific for synovial sarcoma. Although radiographic features of these tumors are not pathognomonic, findings of a soft-tissue mass, particularly if calcified (30%), near but not in a joint of a young patient, are very suggestive of the diagnosis. Cross-sectional imaging features are vital for staging tumor extent and planning surgical resection; they also frequently reveal suggestive appearances of multilobulation and marked heterogenei...

https://pubs.rsna.org/doi/pdf/10.1148/rg.265065084

From the archives of the AFIP: Imaging of synovial sarcoma with radiologic-pathologic correlation.

To characterize the radiological and clinicopathologic features of cystic synovial sarcoma. Seven patients with primary cystic synovial sarcoma were evaluated. Computed tomography (CT) and magnetic resonance (MR) imaging were undertaken at the first presentation. The diagnosis of synovial sarcoma was made on the basis of histological examinations followed by molecular analysis. Radiological and clinicopathologic findings were reviewed. CT showed well-defined soft tissue mass without cortical bone erosion and invasion. Calcification was seen at the periphery of the mass in three cases. T2-weighted MR images showed multilocular inhomogeneous intensity mass in all cases, five of which showed fluid-fluid levels. On gross appearance, old and/or fresh hematomas were detected in six cases. In the one remaining case, microscopic hemorrhage in the cystic lumen was proven. Four cases had poorly differentiated areas. In five cases prominent hemangiopericytomatous vasculature was observed. Histologic grade was intermediate in one tumor and high in six. One case had a history of misdiagnosis for tarsal tunnel syndrome, one for lymphadenopathy, two for sciatica and two for hematoma. All cystic synovial sarcomas demonstrated multilocularity with well-circumscribed walls and internal septae. Synovial sarcoma should be taken into consideration in patients with deeply situated multicystic mass with triple signal intensity on T2-weighted MR imaging.

Cystic synovial sarcomas: imaging features with clinical and histopathologic correlation.

We report the computed tomography (CT) and magnetic resonance imaging (MRI) findings of a rare case of synovial sarcoma of the sternum in an 86-year-old man. CT demonstrated an inhomogenously enhanced soft-tissue-density mass of the sternum that destroyed bone cortex and protruded anteriorly. On MRI, the tumor showed a multinodular mass with internal septation and heterogeneous enhancement. These CT and MRI findings were nonspecific, but were similar to those of soft tissue synovial sarcomas. The tumor was more clearly demarcated by MRI than CT. This is the first report concerning the CT and MRI findings of synovial sarcoma of the sternum. Synovial sarcoma should be added to the gamut of primary malignant neoplasms of the sternum.

Primary synovial sarcoma of the sternum: computed tomography and magnetic resonance imaging findings.

Synovial sarcoma of bone origin is extremely rare and difficult to diagnose. We present a case in which the lesion arose in the cortex of the distal tibia. It showed heterogeneous intermediate signal intensity on T1-weighted images and heterogeneous intermediate to low signal intensity on T2-weighted images with heterogeneous contrast enhancement on MRI. The lesion was confirmed as synovial sarcoma using a combination of histological and molecular genetic studies.

Synovial sarcoma of primary bone origin: A rare case in a rare site with atypical features

Primary renal synovial sarcoma (SS) was first described in 2000 by Argani, with only a few subsequent cases being reported in the English literature. Herein, we describe a case of a 52-year-old woman who presented with right flank pain. Magnetic resonance imaging revealed a 6-cm mass in the lower pole of the right kidney. T1 and T2 weighted imaging revealed a heterogeneous mass with triple sign. There was post-contrast enhancement. Imaging, histology and immunostaining together made the diagnosis of SS of the kidney.

Magnetic resonance imaging features of renal synovial sarcoma: a case report.

A revisit of MRI analysis for synovial sarcoma.

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A revisit of MRI analysis for synovial sarcoma.