Synovial Sarcoma

Synovial sarcoma is a rare form of cancer that affects the tissue around your joints. It typically appears in your hips, knee, ankle or shoulder. It’s a slow-growing cancer with symptoms that develop over time. Early diagnosis and treatment continues to help people live longer after being diagnosed with synovial sarcoma.


Synovial sarcoma (malignant soft tissue tumor) growing in tissue on inner leg near the knee.
Synovial sarcoma (malignant soft tissue tumor) near knee.

What is synovial sarcoma?

Synovial sarcoma is a rare form of cancer that affects the tissue around your joints. It typically appears in your hips, knees, ankles or shoulder. It’s a slow-growing cancer with symptoms that develop over time. Early diagnosis and new treatments are helping people to live longer and with hope for a cure.


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Who does it affect?

Like other malignant soft tissue tumors, synovial sarcoma is an uncommon form of cancer. It affects about 1,000 people each year. It’s most often seen in people under age 30 and more commonly seen in males.

How does this condition affect my body?

Many times synovial sarcoma doesn’t affect your body until the cancerous tumor in your soft tissue grows large enough to create a lump or bump you can see and feel. Some people complain of persistent sharp pain. This usually happens when a tumor is touching nerves in your soft tissue.


What is the survival rate of synovial sarcoma?

The survival rate for synovial sarcoma increased significantly over the past 40 years. Currently, between 59 and 75% of people treated for synovial sarcoma are still alive five years after diagnosis. Unfortunately, synovial sarcoma can reoccur many years later.

How fast does synovial sarcoma grow?

Synovial sarcoma grows very slowly. That’s one reason why you might not notice symptoms right away. The other reason you might not notice symptoms is synovial sarcoma can grow without causing pain.


Symptoms and Causes

What causes synovial sarcoma?

Researchers aren’t sure what causes synovial sarcoma. But they do know it’s related to changes in your chromosomes. A chromosome is a part of your cell that contains your genes. Sometimes your chromosomes break into pieces. The pieces are put back together, but not in the same order or sequence.

For example, if your chromosome was a jigsaw puzzle and your genes were puzzle pieces, the person putting the puzzle together would fit your gene into a spot where it doesn’t belong. In synovial sarcoma, a gene called SYT is jammed up against genes that aren’t the right fit. When this happens, your cells don’t work as they should, and your body develops a mutant gene that causes synovial sarcoma.

What are synovial sarcoma symptoms?

Synovial sarcoma symptoms develop over time. Tumors can grow undetected for as long as two years. Synovial sarcoma symptoms are sometimes mistaken for other, less serious conditions. Follow up with your healthcare provider if you have a symptom that doesn’t go away. Typical symptoms are:

  • A painless lump that appears on your hip, knee, ankle or shoulder.
  • A sudden sharp pain in your hip, knee, ankle or shoulder.
  • Swelling that appears in your hip, knee, ankle or shoulder.

Diagnosis and Tests

How is synovial sarcoma diagnosed?

Healthcare providers begin diagnosis with a physical examination. They might also use imaging tests such as:

  • X-ray: Providers do this test to obtain pictures of your bones and soft tissues.
  • Magnetic resonance imaging (MRI): This is a painless test that uses a large magnet, radio waves and a computer to produce very clear images of organs and structures within your body.
  • Ultrasound: Ultrasounds use high-frequency soundwaves to create real-time pictures and videos of your internal organs or other tissues.
  • Computed tomography (CT) scan: CT scans use a series of X-rays and a computer to create three-dimensional images of your soft tissues and bones.

What other tests are used to diagnose synovial sarcoma?

Providers might perform a biopsy to examine tissue from your suspected tumor. They might also examine tissue cells for changes in your chromosomes.

Management and Treatment

How is synovial sarcoma treated?

Healthcare providers base treatment on factors including the size of your tumor, how long you’ve had the tumor and whether there are signs your tumor has spread. Providers often choose surgery as the first treatment for synovial sarcoma. Other treatments may include:

  • Chemotherapy: Healthcare providers use several types of drugs to kill cancer cells.
  • Radiation therapy: Radiation therapy uses strong beams of energy to kill cancer cells or keep them from growing.
  • Immunotherapy: This treatment works by stimulating your immune system to develop more cancer-fighting cells or healthy cells.
  • Targeted therapy: Targeted therapy uses drugs to block substances in or on cancer cells that allow the cells to grow.
  • Anti-angiogenesis drugs: These drugs block blood vessel formation, essentially killing cancer cells by depriving them of the blood they need in order to grow.

Researchers are now evaluating the benefits of combining radiation, surgery and chemotherapy.

How do I manage treatment side effects?

Every treatment has different side effects. Talk to your healthcare provider about each treatment so you know what to expect, what your provider can do to help you, and what you can do to help yourself.


Can synovial sarcoma be prevented?

Unfortunately, there aren’t ways to prevent synovial sarcoma. That’s because it’s likely caused by changes in your chromosomes, and that’s not something you can control.

One thing you can control is being aware of changes in your body. A lump on your legs and arms that doesn’t go away or is painful might be something your healthcare provider should check. Finding synovial sarcoma early improves your chances of a full recovery.

Outlook / Prognosis

What can I expect if I have synovial sarcoma?

Healthcare providers have made huge strides in treating synovial sarcoma. That being said, there’s still a chance synovial sarcoma will reoccur, sometimes many years after treatment. Given that, you’ll probably have regular checkups for the first several years after treatment. Your providers will watch for any sign your cancer has returned or surfaced in another area of your body.

Living With

How do I take care of myself if I’m diagnosed with synovial sarcoma?

The first step is staying strong through treatment. You might have a combination of chemotherapy, surgery and radiation that can take a toll on your body:

  • Chemotherapy treatments might affect your appetite. Try to eat a healthy diet, and talk to a nutritionist if you’re having trouble eating.
  • If you had surgery, you might benefit from physical therapy to help you regain your strength.
  • Get plenty of rest.
  • Cancer is stressful. You might find activities such as meditation, relaxation exercises or deep breathing help to ease your stress.
  • Reach out for support from others who’ve been in your situation. Your healthcare provider can direct you to support groups and programs where you can share your thoughts and feelings with people who understand what you’re going through.

When should I see my healthcare provider?

You’ll have regular visits with your healthcare provider as you go through treatment. Once treatment is completed, you’ll probably have regular follow-up appointments for the next several years.

What questions should I ask my healthcare provider?

You’ll have different questions during diagnosis, treatment and follow up. Some basic questions might be:

  • Where is my cancer?
  • What caused my cancer?
  • What stage is my cancer?
  • Has my cancer spread?
  • What treatments do you recommend, and why?
  • What are the recommended treatment side effects?
  • What are the chances my cancer will come back?

Additional Common Questions

What are differences between synovial sarcoma and other soft tissue sarcomas?

Both conditions have similar symptoms and treatments but different risk factors. Some soft tissue sarcomas are linked to certain inherited disorders, while synovial sarcoma is believed to be caused by changes in your chromosomes.

A note from Cleveland Clinic

Any cancer diagnosis can launch a tidal wave of emotions as you come to terms with your situation. Being diagnosed with a rare form of cancer can be even more difficult. It’s important that you give yourself time and space to understand your illness and your treatment options. Knowing your choices and what to expect can help ease your anxiety. Your provider is there to answer your questions and make sure you are comfortable with your choices.

Medically Reviewed

Last reviewed by a Cleveland Clinic medical professional on 11/08/2021.

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