Sarcomas are represented by a rather numerous list of varieties: chondrosarcomas, osteosarcomas, fibrosarcomas, synovial sarcomas, etc. Some tumors affect bone tissues, others - muscle, others - vascular, etc.
There are also sarcomas that affect articular structures. They are called synoviomas or synovial sarcomas.
Concept of the disease
So, synoviomas are malignant lesions that affect the soft tissues of the articular structures of the extremities and neck.
Approximately in half of the cases, lesions are localized on the knee joints, slightly less on the hands, and a very small number of cases of malignant synovia occur in the cervical region.
Similar pathologies are characterized by high recurrence, appearing repeatedly after 1-3 years.
Malignant synoviomas metastasize primarily into pulmonary and bone marrow tissues, lymph nodes, etc. Sometimes metastases are detected in the brain, cardiac or prostatic tissues.
Similar tumors are considered very dangerous and rapidly progressing, they do not respond well to the therapeutic effect, therefore they require a highly qualified approach to treatment.
Causes of pathology
Medicine is not aware of the causes of malignant synovia, therefore, only a few common factors that influence the development of pathology are identified:
- Radiation exposure;
- Predisposition of hereditary character;
- Carcinogenic effects of various chemicals;
- Synoviomas often develop against the backdrop of treatment of cancers through immunosuppressive therapeutic effects;
- Traumatic factors.
This pathology is closely related to chromosomal translocation, which is the cause of the formation of mutant genes, which in the future also provoke the formation of malignant synovia.
Classification of
Synovial sarcomatous formations are distinguished by a rather extensive classification.
By structure, such formations are divided into biphase or monophasic. Biphasic formations are formed from sarcoma and epithelial precancerous components. Monophasic tumors consist of sarcomatous and epithelial cells, and are structurally reminiscent of hemangiopericytomas.
According to morphological indicators, synovial sarcomatous tumors are divided into cellular and fibrous tumors. Cellular formations are formed from glandular cells, and fibrous formations have a fibrous structure and are similar in structure to fibrosarcoma.
According to microscopic features, sarcomatous synovial formations are classified into:
- Fibrous;
- Giant cell;
- Adenomatous;
- Mixed;
- Alveolar;
- Histoids.
The consistency of malignant synoviomas is mild and firm. The former are characteristic of cellular formations, and solid appear when the tumor is impregnated with calcium salts.
Symptoms of synovial sarcoma
Synovial sarcomatous tumors are considered to be the most malignant soft-tissue tumors.
They differ rather bright symptomatology and early displays of soreness.
In addition, there are signs of hyperthermia, lethargy and fatigue, motor limitations, numbness, lack of appetite, etc.
Knee joint
Knee-joint sarcoma synovial type is a malignant tumor of predominantly secondary origin.
Most often, such synoviomas are formed as a result of metastasis of the tumor process from the pelvic zone or due to the defeat of the popliteal lymph nodes.
Knee synoviomas may be chondrosarcomas or osteosarcomas. The main features of the formations are:
- Intensive pain;
- Movement disorders.
When the knee-joint synovium extends to tendons and ligament structures, the leg will lose motor function. Gradually, the tissues of the knee begin to break down, which makes the limb unable to move. In tissues located below the knee joint, under the influence of the tumor process blood supply and nutrition are disturbed.
Shoulder joint
Sarcomatum synovial tumors in the shoulder joint can develop in the form of fibrosarcoma or osteosarcoma affecting soft tissue and bone structures.
Such sarcomatous formations are primary or secondary. The secondary form of the tumor occurs due to metastasis from the thyroid or breast.
Initially, the synovium develops imperceptibly, it can be detected only with ultrasound diagnosis. However, with further development of the tumor, soreness appears, the color changes over the formation, deformations of the shoulder joint occur.
For treatment, a complex approach is usually used with the use of surgical techniques, chemotherapy and radiation exposure.
Diagnosis and treatment
Diagnostic studies require high professionalism, as pathology is often mistaken for other diseases.
Diagnostics consists in carrying out such procedures:
- Biopsy;
- Immunological analysis of education;
- Angiographic examination of blood vessels in the area of tumor localization;
- Genetic diagnostics for determination of anomalies in chromosomes;
- Radiography of articular tissues;
- Radioisotope scanning.
After the diagnosis is clarified, the patient is selected the necessary treatment. Usually it consists of traditional surgical, radiotherapy and chemotherapy.
Surgical treatment implies the removal of the tumor within the boundaries of healthy tissues, but if the formation has grown to large sizes, then its expanded excision with surrounding tissue and removal of lymph nodes and sometimes the entire joint is shown.
If the entire joint is removed, then its plastic, prosthetics, is carried out, which restores the patient mobility. When metastases are detected, they are also removed.
Radiation therapy is considered an effective method of treating synovia. Usually, the irradiation is performed before the operation to reduce the size of the formation and to stabilize its growth. After the operation, irradiation is prescribed to eliminate metastases. Usually, several courses of radiotherapy are conducted at short intervals.
Chemotherapeutic effect is used as a palliative treatment in the final stages of the tumor process. Antitumor drugs like Carminomycin and Adriamycin are used. As a result, the tumor slows down its growth, the soreness decreases, which improves the patient's condition.
But the chemotherapeutic effect is justified only when the tumor is sensitive to cytostatic drugs.
Prognosis for
Prognosis for malignant synoviomas is negative in most cases, survival is about 40%.
The chances of survival in patients are as high as possible only when the sarcomatous synovial tumor is detected at the first stage. In this scenario, the survival rate can reach 80%.
The probability of metastasis is constantly increasing, therefore at the first signs of the tumor process it is necessary to consult a specialist.
Video on synovial soft tissue sarcoma: