Materiały źródłowe

• #1 Synovial Sarcoma: Symptoms, Treatment & Prognosis

  https://my.clevelandclinic.org/health/diseases/22012-synovial-sarcoma

  Synovial sarcoma is a rare, slow-growing soft tissue cancer. It doesnt always cause pain, and symptoms can resemble those of other, more common health conditions like arthritis or bursitis. […] Synovial sarcoma grows very slowly and may not cause pain. Many times, you wont have symptoms until the tumor grows large enough to create a lump you can see and/or feel. Some people develop pain or numbness, especially if the tumor presses on nerves as it grows. […] Synovial sarcoma cancer develops gradually over time. Tumors can grow undetected for up to two years. During this time, you may not have any symptoms at all. Once symptoms occur, they may include: A lump you can see and feel. (The lump might be painless.) Numbness, Pain, Swelling. […] Synovial sarcoma symptoms can look and feel like symptoms of other, less serious conditions like arthritis or bursitis. Because of this, synovial sarcoma may go undetected for a time. If you notice any kind of lump under your skin, schedule an appointment with a healthcare provider and see them as soon as possible.

• #2 Synovial sarcoma – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/synovial-sarcoma/symptoms-causes/syc-20577380

  Synovial sarcoma begins as a growth of cells that can multiply quickly and destroy healthy tissue. The first symptom is usually swelling or a lump under the skin. The lump may or may not hurt. […] Signs and symptoms of synovial sarcoma depend on where the cancer starts. Most people notice a painless lump or bump that slowly gets bigger. The lump usually starts near the knee or ankle, but it can appear on any part of the body. […] Synovial sarcoma symptoms may include: A lump or bump under the skin that slowly gets bigger. Joint stiffness. Pain. Swelling. […] Synovial sarcoma that happens in the head or neck can cause other symptoms. These may include: Problems breathing. Difficulty swallowing. Changes in the way the voice sounds.

• #3 Synovial Cell Sarcoma – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK587366/

  Synovial sarcoma is a mesenchymal tumor that presents mainly in adolescents and adults younger than 30. […] It is a very aggressive malignancy with a high potential for metastasis. […] Typically, synovial sarcoma arises from deep soft tissues of the extremities. […] In the extremity, the patient usually presents with a deep-seated enlarging mass that is hard in consistency, usually slightly movable within the muscle (unless fixed to the bone or fascia) and is not tender. […] In patients with visceral SS, the symptoms usually localize according to the organ of involvement. […] It is often not possible to establish a diagnosis of SS clinically. However, the index of suspicion for SS should be high if a previously young, healthy patient in the adolescent/young adult age group presents with a hard mass in the extremity or elsewhere in the body.

• #4 Synovial Sarcoma of the Extremities: A Literature Review

  https://www.mdpi.com/2076-3417/11/16/7407

  The certain diagnosis of synovial sarcoma remains a challenge and the recognition of the disease should be based upon a combination of findings, including traditional morphology, detection of the chromosomal t (X; 18) translocation and a panel of immunohistochemical markers. […] The potential aggressive behavior of synovial sarcoma makes the pathological and radiological evaluations very important for an appropriate staging and an adequate therapeutical decision. […] Usually, the tumor presents as a palpable soft-tissue mass or swelling, with a long period between clinical onset and the diagnosis, particularly due to the initial slow growth of the lesion (average 2–4 years).

• #5 Synovial sarcoma: the misdiagnosed sarcoma in: EFORT Open Reviews Volume 9 Issue 3 (2024)

  https://eor.bioscientifica.com/view/journals/eor/9/3/EOR-23-0193.xml

  Synovial sarcoma is a rare and highly malignant soft tissue sarcoma. The inconspicuous and diversity of its early symptoms make it a highly misdiagnosed disease. […] The management of synovial sarcomas is challenging as they are rare and have a poor prognosis. Early and correct diagnosis and treatment are critical for clinical outcomes. Misdiagnosis or delayed diagnosis can have devastating consequences for the patient. […] The inconspicuousness and diversity of early symptoms and the rarity of SSs pose a certain influence on patient presentation and clinical diagnosis. This makes the disease highly susceptible to delayed awareness and misdiagnosis. A study performed by Chotel et al. found that only half of SS patients had typical STS symptoms and the mean duration of symptoms before diagnosis was 98 weeks. Presenting a mean diagnosis delay caused by patients (from the time at which symptoms were first noted until the time when the patient first consulted a doctor) of 43 weeks and a mean diagnosis delay caused by doctors (from the first medical visit until an accurate diagnosis was established) of 50 weeks. More importantly, the delay did not improve significantly over the study’s 21-year period.

• #6 Synovial Sarcoma: Treatment, Symptoms, and Causes

  https://www.healthline.com/health/synovial-sarcoma

  Synovial sarcoma doesnt always cause symptoms in the early stages. As the primary tumor grows, you may have symptoms similar to those of arthritis or bursitis, such as: swelling, numbness, pain, especially if the tumor is pressing on a nerve, limited range of motion in an arm or leg. […] You may also have a lump you can see and feel. If you have a mass in your neck, it may affect your breathing or change your voice. If it occurs in your lungs, it can lead to shortness of breath. […] Synovial sarcoma can spread to other parts of your body, even when its been dormant for some time. Until it grows to a substantial size, you may not have symptoms or notice a lump. […] The most common site of metastasis is the lungs. It can also spread to lymph nodes, bone, and your brain and other organs.

• #7 Synovial Sarcoma: Causes, Symptoms, and Treatment

  https://www.medicoverhospitals.in/diseases/synovial-sarcoma/

  Recognizing the symptoms of synovial sarcoma can lead to early diagnosis and better treatment outcomes. Symptoms often vary depending on the tumor’s size and location. […] Symptoms include a painless lump, swelling, and sometimes pain near joints, often in the arms or legs. […] A noticeable lump or swelling near a joint is one of the most common symptoms. This lump is usually painless but can become painful over time. […] Persistent pain near a joint that worsens with activity or at night. […] Difficulty moving the affected limb or joint. […] In some cases, the tumor may press against nerves, causing numbness or tingling. […] Feeling unusually tired or weak. […] Unexplained weight loss without changes in diet or exercise. […] Occasional low-grade fever.

• #8 Synovial Sarcoma | Causes, Symptoms, Diagnosis & Treatment

  https://www.cincinnatichildrens.org/health/s/synovial-sarcoma

  Symptoms of synovial sarcoma vary depending on the tumors size and location. […] Symptoms of synovial sarcoma appear near where the tumor is located. They may include: Swelling, A tumor that can be felt, usually deep in the tissue, Pain that lasts a long period of time. […] Prompt diagnosis and treatment can significantly improve the outcome for patients with synovial sarcoma.

• #9 Synovial sarcoma: the misdiagnosed sarcoma in: EFORT Open Reviews Volume 9 Issue 3 (2024)

  https://eor.bioscientifica.com/view/journals/eor/9/3/EOR-23-0193.xml

  SS is considered to be a high-grade STS with a tendency to be locally aggressive and metastatic; therefore, early diagnosis and treatment is crucial for the patient’s prognosis. However, the high rate of delay and misdiagnosis of SS in current clinical diagnosis has negative consequences for patients. […] In the early stages, small SSs may cause insignificant signs or symptoms. As the tumor grows larger, the patient may notice a mass or swelling of the affected region. In some cases, the tumor can limit the range of motion or cause numbness and/or pain if it located next to nerves. The common clinical appearance is a slow-growing, painless mass and may give the false impression of being benign. So, SS is frequently initially misdiagnosed as a benign lesion (also as hematoma) because of its small size, slow growth rate, well-defined circumscription, insidious onset, younger age at presentation, and atypical presenting symptoms.

• #10 Mayo Clinic Health Library – Synovial sarcoma | Swiss Medical Network

  https://www.swissmedical.net/en/healtcare-library/con-20129022

  Synovial sarcoma usually affects young adults. […] The first symptom is usually swelling or a lump under the skin. The lump may or may not hurt. […] Most people notice a painless lump or bump that slowly gets bigger. The lump usually starts near the knee or ankle, but it can appear on any part of the body. […] Synovial sarcoma symptoms may include: A lump or bump under the skin that slowly gets bigger. Joint stiffness. Pain. Swelling. […] Synovial sarcoma that happens in the head or neck can cause other symptoms. These may include: Problems breathing. Difficulty swallowing. Changes in the way the voice sounds.

• #11 Synovial Cell Sarcoma – MD Searchlight

  https://mdsearchlight.com/child-health/synovial-cell-sarcoma/

  Synovial sarcoma is a type of cancer that generally originates from deep tissues in arms and legs. However, it can also affect other parts like the chest, back, and neck. In some rare instances, it can show up in parts like the lungs, heart, gastrointestinal tract, and other organs. Usually, a hard-growing lump that can slightly move within the muscle (unless it’s attached to the bone or a band of connective tissue known as fascia) is spotted. Other than this, the person’s medical history is generally normal. For people who have the disease in an internal organ, the symptoms will differ based on which organ is affected. For instance, if synovial sarcoma affects the prostate, it can cause difficulty in urinating. If it affects the lungs, symptoms similar to pneumonia, chest pain, or even blood clot in the lung can occur.

• #12 Synovial sarcoma | Beacon Health System

  https://www.beaconhealthsystem.org/library/diseases-and-conditions/synovial-sarcoma?content_id=CON-20129022

  Synovial sarcoma usually affects young adults. […] The first symptom is usually swelling or a lump under the skin. The lump may or may not hurt. […] Most people notice a painless lump or bump that slowly gets bigger. The lump usually starts near the knee or ankle, but it can appear on any part of the body. […] Synovial sarcoma symptoms may include: A lump or bump under the skin that slowly gets bigger. Joint stiffness. Pain. Swelling. […] Synovial sarcoma that happens in the head or neck can cause other symptoms. These may include: Problems breathing. Difficulty swallowing. Changes in the way the voice sounds. […] Synovial sarcoma is usually slow growing, so it can be years before a diagnosis is made.

• #13 Synovial Sarcoma – NCI

  https://www.cancer.gov/pediatric-adult-rare-tumor/rare-tumors/rare-soft-tissue-tumors/synovial-sarcoma

  Synovial sarcoma is a cancer that can come from different types of soft tissue, such as muscle or ligaments. It is often found in the arm, leg, or foot, and near joints such as the wrist or ankle. […] The symptoms caused by synovial sarcoma depend on where the tumor forms. Synovial sarcoma is often first noticed as a painless lump. If it is near a nerve, it might cause pain or numbness as it grows. […] Given that synovial sarcoma can grow for a while before it is found, there is a greater chance that it will spread to other parts of the body. […] Doctors estimate synovial sarcoma survival rates by how groups of people with synovial sarcoma have done in the past. Given that there are so few synovial sarcoma patients, survival rates may not be very accurate. They also dont consider newer treatments being developed. We know that anywhere from 36% to 76% of people with synovial sarcoma will be alive five years after their first diagnosis. Chances of survival are better if the tumor is completely removed and does not return or spread.

• #14 Synovial Sarcoma of the Extremities: A Literature Review

  https://www.mdpi.com/2076-3417/11/16/7407

  Synovial sarcoma (SS) is a rare and highly malignant tumor and a type of soft tissue sarcoma (STS), for which survival has not improved significantly in recent years. Synovial sarcomas occur mostly in adolescents and young adults (15–35 years old), usually affecting the deep soft tissues near the large joints of the extremities, with males being at a slightly higher risk. […] In the early stages, small synovial sarcomas may cause insignificant signs or symptoms. As the tumor grows larger, the patient may notice a mass or swelling of the affected region. In some cases, the tumor can limit the range of motion or cause numbness and/or pain if it presses on nearby nerves. The common clinical appearance is a slow-growing painless mass and may give the false impression of being benign. Based on the tumor location, some functional impairment may appear.

• #15 Synovial Sarcoma – SFA

  https://curesarcoma.org/sarcoma-subtypes/synovial-sarcoma/

  Synovial sarcoma is a rare and aggressive soft tissue sarcoma characterized by spindle cells and variable epithelial differentiation, typically involving the extremities. […] SS usually presents as a swelling (sometimes longstanding), which may be painful. The initial growth of SS is often slow, and a small circumscribed tumor may give the wrong impression of a benign lesion by clinical examination and imaging. SS may have radiologically detectable stippled or spiculated forms of calcification. SS with aggressive growth may erode or invade adjacent bone. […] Clinical series of SS patients have reported 5-year and 10-year overall survival rates of approximately 50–60% and 40–50%, respectively. Prognosis depends on factors such as tumor size, location, and the presence of metastasis at diagnosis. The presence of an SS18-SSX2 fusion is associated with a better prognosis compared to SS18-SSX1.

• #16 Synovial sarcoma | Radiology Reference Article | Radiopaedia.org

  https://radiopaedia.org/articles/synovial-sarcoma?lang=us

  Synovial sarcomas are relatively common intermediate-to-high grade malignant soft tissue tumors, often with an initial indolent course, affecting young patients and most commonly involving the soft tissue surrounding the knees. […] The presentation is most often with a slowly enlarging soft tissue mass, which may have been noted for some years and gives a false impression of a benign process. […] Overall 5-year survival is between 36-76%. Both local recurrence (30-50%) and distant metastases are frequent (40-70%), most commonly to the lungs as cannonball metastases (~80%), bones (~15%), regional lymph nodes (~10%), followed by chest wall/abdomen (~7.5%).

• #17 9 synovial sarcoma questions, answered | MD Anderson Cancer Center

  https://www.mdanderson.org/cancerwise/synovial-sarcoma.h00-159068712.html

  Most synovial sarcoma patients discover their tumor from a lump, and for some, related pain. Its important to see a doctor if you find a lump or have persistent, unprovoked pain in a soft tissue, such as the muscle of an extremity or from within your abdomen. Synovial sarcoma may also occur in the lungs, so see your doctor if you notice shortness of breath. […] Synovial sarcoma often does spread to other parts of the body. The lungs are the most common, and usually the first, site of metastasis for synovial sarcoma. Metastasis to the brain, bone, lymph nodes and local organs are all possibilities. […] Synovial sarcoma can be inactive for a long time before it grows again to a size that can be detected by a scan. So make sure you continue to get your regular scans and follow-ups with your doctor, even if you’ve had no evidence of disease for many years. That way, if your cancer does return, we can find it as early as possible, when it’s more treatable.

• #18 Synovial sarcoma in adults | Sarcoma UK

  https://sarcoma.org.uk/about-sarcoma/what-is-sarcoma/types-of-sarcoma/synovial-sarcoma/synovial-sarcoma-in-adults/

  Synovial sarcoma usually develops in cells around joints and tendons. […] Symptoms of synovial sarcoma can vary depending on the size and location of your tumour. You may experience all, some or none of these symptoms before you are diagnosed with synovial sarcoma: A lump or swelling in the soft tissue of the body under the skin, often around the joints in the arms or legs. This lump is often slow-growing to begin and painful. […] Synovial sarcoma can reappear in the same area after the treatment of a previous tumour; this is called a local recurrence. […] A recurrence of synovial sarcoma may be accompanied by cancer in other parts of the body. This is called metastasis or secondary cancer. Some people are diagnosed with sarcoma because their metastases have been discovered before their primary synovial sarcoma tumour. In synovial sarcoma patients, these secondary cancers may appear in the lungs, which is why a chest x-ray is taken at follow-up appointments.

• #19 Relapsed synovial sarcoma | CMAR

  https://www.dovepress.com/treatment-at-relapse-for-synovial-sarcoma-of-children-adolescents-and–peer-reviewed-fulltext-article-CMAR

  While the overall prognosis is generally quite satisfactory in children and adolescents with localised synovial sarcoma at diagnosis, the outcome remains poor for patients with initial metastatic disease or after relapse. […] Approximately 25-32% of patients experience recurrence with a median time to relapse of 24 months. […] The main findings of these studies are summarised in Table 1: relapse was local in 50-73% of the cases and metastatic in 27-66%, with median time to relapse of 20-30 months. The 5-year post-relapse OS ranged from 30% to 46%. […] Type of recurrence influenced post-relapse survival in all the series, with patients with local recurrence having a better outcome than those with metastases. […] Therefore, complete surgical resection of a local relapse is required to achieve the best outcomes.

• #20

  https://www.orthobullets.com/pathology/8052/synovial-sarcoma

  Synovial Sarcoma is a malignant, soft tissue sarcoma caused by a t(X;18) chromosomal translocation mutation ( SS18:SSX fusion protein) most commonly found near joints but rarely within the joint. […] The condition usually presents in patients between 15 and 40 years old with a growing mass in proximity to a joint. […] Symptoms typically present as a slow growing mass in proximity to a joint. […] Symptoms may be painless or painful. […] Most commonly occur in periarticular locations (knee, shoulder, elbow, foot). […] 60% are found in the lower extremity. […] Metastasis may develop in 30-60% of patients. […] Metastasis is more common with large, deep, and high grade sarcomas. […] Overall prognosis is poor. […] 5 year survival is approximately 50-60%. […] 10 year survival is approximately 25%. […] Prognostic factors include size, grade, location, patient age, and surgical margins. […] SYT-SSX fusion type is most important prognostic factor.

• #21

  https://link.springer.com/article/10.1245/s10434-017-5855-x

  Synovial sarcoma is a translocation-associated soft-tissue malignancy that frequently affects adolescents and young adults. […] Prognosis of patients with recurrent or metastatic disease is generally poor, and newer therapeutic strategies are needed. […] The SYT-SSX1 variant of synovial sarcoma is associated with a high rate of tumor cell proliferation and poor clinical outcome. […] Prognostic factors in advanced synovial sarcoma: an analysis of 104 patients treated at the Royal Marsden Hospital. […] The classic prognostic factors tumor stage, tumor size, and tumor grade are the strongest predictors of outcome in synovial sarcoma: no role for SSX fusion type or ezrin expression. […] Age as an independent prognostic factor for survival of localised synovial sarcoma patients. […] Prognostic implication of SYT-SSX fusion type in synovial sarcoma: a multi-institutional retrospective analysis in Japan. […] Long-term treatment outcomes for patients with synovial sarcoma: a 40-year experience at the University of Florida. […] Long-term outcomes for synovial sarcoma treated with conservation surgery and radiotherapy.

• #22 Orphanet: Synovial sarcoma

  https://www.orpha.net/en/disease/detail/3273

  A rare soft tissue sarcoma characterized by palpable, slow-growing, deep-seated swellings, with or without pain or tenderness, affecting mostly children and young adults. Patients may have pain or joint contractures that precede swelling. […] Increasing size, age and tumor grade are reported as negative predictive factors for both local disease recurrence and metastasis.

• #23 Synovial Cell Sarcoma – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK587366/

  The treatment of patients with synovial sarcoma is based on the stage of presentation. A patient with SS can either present with localized or metastatic disease. […] Treating patients with locally advanced unresectable or metastatic synovial sarcoma aims at palliation and prolonging life. […] Synovial sarcoma is an aggressive malignancy with a poor prognosis. […] The expected 5-year survival is between 50-60% in adults, and 5-year metastasis-free survival is between 40 to 60%. […] Compression of the nearby structures due to the „mass effect” of the growing tumor can lead to various compressive issues. […] Synovial sarcoma rarely metastasizes to the brain and can lead to seizures and other neurologic complications.

• #24 Synovial sarcoma of the buttocks presenting with a non-healing wound and rapid progression after local resection: a case report | World Journal of Surgical Oncology | Full Text

  https://wjso.biomedcentral.com/articles/10.1186/1477-7819-10-125

  Synovial sarcoma is a malignant mesenchymal neoplasm that is frequently misdiagnosed as a benign condition because of its small size, slow growth, and well-delineated appearance. […] Here we report a case of synovial sarcoma of the buttocks presenting with a non-healing wound and rapid progression after local resection in a 23-year-old woman. […] Postoperatively, she developed a non-healing wound that did not respond to conventional antibiotic therapy and local wound care, and pitting edema of the lower extremities. […] Her condition deteriorated dramatically shortly thereafter; she developed systemic edema and died of respiratory failure. […] This case suggests that synovial sarcoma may be fatal within months of recognition if improperly managed and stresses the importance of adequate pre-surgical evaluation and postoperative pathological analysis in the management of a subcutaneous mass.

• #25

  https://journals.lww.com/md-journal/fulltext/2020/12110/synovial_sarcoma_of_the_spine_in_the_lumbar.69.aspx

  Synovial sarcoma (SS) is a soft tissue neoplasm that rarely occurs in the vertebral body and should be considered in the differential diagnosis in patients with SS and vertebral lesions. SS often presents as a painless mass in the spine, which may undergo slow enlargement, resulting in sustained symptoms of neurologic deficit and pain. […] A 56-year-old woman experienced pain in her waist for 3 months. She occasionally experienced bilateral costal paresthesia and lower extremity or dysfunction and pain in the lower extremities and bladder. The most serious symptom was pain in the lumbar vertebrae, and oftentimes, this was the only symptom. […] The initial treatment of posterior laminectomy decompression and percutaneous vertebro plasty (PVP) was performed, however, this initial treatment course was inappropriate, but she eventually underwent L-2 complete resection and internal fixation. After the second surgery, she was treated by external beam radiation therapy.

• #26 Early progression of a pancreatic metastasis of synovial sarcoma after pancreatectomy | Surgical Case Reports | Full Text

  https://surgicalcasereports.springeropen.com/articles/10.1186/s40792-023-01612-z

  Synovial sarcoma is a malignant tumor that constitutes up to 10% of all soft-tissue sarcomas. The most frequent metastatic sites of synovial sarcoma are the lungs, lymph nodes, and bone, whereas pancreatic metastasis is extremely rare. […] The doubling time of the pancreatic tumor was 14 days, and it grew rapidly. Furthermore, treatment-resistant pancreatitis symptoms were detected; thus, we performed distal pancreatectomy and administered one course of a 70% dose of trabectedin. However, the patient died of rapid progression of lung metastasis and respiratory failure within 2 months after surgery. […] The diagnosis was pancreatic metastasis of SS, with obstructive pancreatitis and progressive bilateral multiple lung metastases. […] The patient subsequently experienced rapid progression of the lung metastasis and died of respiratory failure within 2 months after surgery. […] Pancreatectomy may be carefully performed in cases of isolated pancreatic metastasis. However, the presence of other distant extrapancreatic metastases (e.g., uncontrolled lung metastases) may rule out pancreatectomy treatment.

• #27 Reddit – The heart of the internet

  https://www.reddit.com/r/sarcoma/comments/tfy6kc/synovial_sarcoma_update/

  Hi friends, quick update. I was told today that unfortunately, my synovial sarcoma is incurable. Prognosis AVERAGE was 18 months but the doctor thinks I will do better as I am younger (31) and still wants to treat me with chemo as she says it will improve my quality of life. […] I start inpatient chemo on Monday.

• #28 Synovial Sarcoma survivors wanted! Would love to hear stories! — Cancer Survivors Network

  https://csn.cancer.org/discussion/167737/synovial-sarcoma-survivors-wanted-would-love-to-hear-stories

  My name is Scarlett, I am 19 years old and I live in San Diego, California. Last February I was diagnosed with synovial sarcoma. It was in my left forearm. I had a chest ct, bone scan, and pet scan which all showed no evidence of metastasis. I started with radiation to help shrink the tumor. After that finished, I had a surgery to remove the tumor as well as a sentinel node biopsy. The node biopsy was clean and the surgery was successful, my doctor was able to spare a lot of the function of my arm and thankfully, it functions very well despite the fact. The frustrating part came after surgery. My doctors were all on the fence about whether or not I needed chemo. It took a lot of thought, discussion, and research, but ultimately I made the decision to do chemo. I thought that I would feel better with the notion that I did everything I could to fight it. I had six treatments of Adriamyacin and Ifosfomide cocktails. I really don’t remember much of the treatment, the drugs made me pretty delusional. I have had an MRI and a Chest CT and they both have shown „no evidence of recurrence.” I have been given a pretty good prognosis and my test results have worked out in my benefit. However, I still can’t really kick the negative thoughts. I get so worried sometimes that I can’t sleep or that I have paranoid feelings. Going to the doctor makes me so anxious that I feel sick to my stomach. I have had two friends pass away in the last 6 months (one to metastatic osteosarcoma, one to breast cancer) and I feel like all that surrounds me is these dismal stories. I have developed a cough it is probably a cold but my fear is it has spread to my lungs, I tell myself I am stupid to worry and it is probably nothing but this is what I thought before I was diagnosed last year. I have a really supportive team behind me but its tough to find somebody that can actually relate. I have had an MRI done. The first surgeon I saw sent me to an orthopedic surgeon who referred me to an orthopedic oncologist. Talk about scary! Even though my kids are in their late teens, I still didn’t want to leave them. I went through 25 radiation treatments, I had surgery to remove the tumor in July, all margins were clean. I firmly believe that I was cancer-free at that point. However, just to be sure, I went through the in-patient chemo that you did, Scarlett, same chemo cocktails, just longer. The worst part was that I was in a hospital about 60 miles away from friends and family and I was very, very lonely. I am still very fatigue and have even tried to change how I eat. This has been an extremely difficult situation for me to handle I have a 3 year old son and a husband. I now have a lot of anxiety, and depression and my goodness fear of my next doctors appointment. I also always try to hide my arm now in fear of people seeing such a huge scar. I have been seeing a therapist and started taking an anti-anxiety medication to help combat the feelings. But its so intense sometimes and I feel like I really don’t have many people to turn to…especially my friends. I have been going for checkups every three months now they are every 6 months. Even after 3 years a survivor I still get very anxious before every visit. The only advice I can give is think positively as I am sure one day the visits will get a lot easier. I have had two friends pass away in the last 6 months (one to metastatic osteosarcoma, one to breast cancer) and I feel like all that surrounds me is these dismal stories. I have developed a cough it is probably a cold but my fear is it has spread to my lungs, I tell myself I am stupid to worry and it is probably nothing but this is what I thought before I was diagnosed last year.

• #29 Synovial Sarcoma behind left knee, unsuccessful chemotherapy and low looking at amputation half way up thigh – Macmillan Online Community

  https://community.macmillan.org.uk/cancer_types/soft-tissue-sarcomas-forum/f/diagnosis-and-treatment/262852/synovial-sarcoma-behind-left-knee-unsuccessful-chemotherapy-and-low-looking-at-amputation-half-way-up-thigh

  Amputation is very daunting but probably has my best outcome. […] I had three rounds of very heavy chemo but the lump has not shrunk, in fact it has grown a bit. […] The surgeon seems more confident about the amputation – half way up my thigh. It is a lot to think about.

• #30 Synovial (soft tissue) sarcoma: What to know

  https://www.medicalnewstoday.com/articles/synovial-sarcoma

  Because synovial sarcoma is rare, it is difficult for doctors to gauge survival rates accurately. […] According to the NCI, between 36% and 76% of people with synovial sarcoma survive for at least 5 years after their diagnosis. […] Synovial sarcoma is a form of soft tissue sarcoma and a rare form of cancer. It can present with few symptoms at first but very often spreads. It can cause pain, joint movement issues, and swelling.

• #31 Relapsed synovial sarcoma | CMAR

  https://www.dovepress.com/treatment-at-relapse-for-synovial-sarcoma-of-children-adolescents-and–peer-reviewed-fulltext-article-CMAR

  The main prognostic variables can be used to estimate post-relapse survival, for the purposes of planning risk-adapted salvage protocols. […] In fact, in the subset of patients without any risk factor (only 7 out of 41 cases analysed for this purpose), 5-year OS was 85.7%; when at least one factor was present (early relapse or metastatic, secondary remission not reached), 5-year OS drastically decreased to 18.7%. […] In general, there is a consensus that patients with exclusive local relapse should promptly receive microscopically complete tumour resection, whenever possible. […] Local treatments (surgery and radiotherapy) remain a key stone of the therapeutic approach. […] In case of metastatic relapse, systemic therapy used in neo-adjuvant setting should have a major role, with local treatment in case of concomitant local relapse and treatment on metastases (surgery/radiotherapy/thermal ablation) depending on site, number and size of metastatic lesions.

• #32 Childhood Synovial Sarcoma | Dana-Farber Cancer Institute

  https://www.dana-farber.org/cancer-care/types/childhood-synovial-sarcoma

  Synovial sarcoma, a malignant soft tissue tumor often located in the extremities, is so named because it exhibits a microscopic resemblance to synovial tissue, the lining found within joints, though it is not thought to originate from this tissue. […] Predominantly affecting adolescents and young adults, synovial sarcoma displays a higher occurrence in males. While its primary site is in the extremity, it can manifest in many locations throughout the body. The tumor has the potential to metastasize, particularly involving regional lymph nodes. Distant tissue spread occurs in approximately half of all cases, often months to years post initial diagnosis, though it can also be present at the time of diagnosis. […] Over 70 percent of children with synovial sarcoma will survive five years after diagnosis if they have localized disease and receive combination therapy. […] Unfortunately, about 40 percent of children treated for synovial sarcoma will experience a relapse or disease return.

• #33 Can Synovial Sarcoma Be Cured? Treatment & Survival Rates

  https://www.medicinenet.com/can_synovial_sarcoma_be_cured/article.htm

  Synovial sarcoma can be cured if detected in the early stages. However, this cancer rarely causes any signs and symptoms during early stages. It is an aggressive type of sarcoma that may have already spread in the body by the time it is diagnosed. […] Synovial sarcoma generally does not cause symptoms during the initial stages. Usually, the patient reports: A small lump, often painless, that has rapidly increased in size. As the tumor increases in size, it may cause symptoms such as pain, numbness, and reduced range of motion. […] Timely diagnosis is the key to proper treatment. A painless lump anywhere in the body must be investigated as soon as possible.

• #34 Synovial Sarcoma Symptoms – DNA Labs India

  https://dnalabsindia.com/rare-forms-of-cancer/synovial-sarcoma-symptoms

  Synovial sarcoma, a rare type of cancer that affects the areas around joints, requires early detection for effective management and a hopeful prognosis in India. […] The early symptoms of synovial sarcoma can be easily overlooked. However, recognizing these signs early on is vital as it enables access to more effective treatments such as surgery or radiation therapy, significantly improving treatment outcomes. Early treatment is crucial because: […] Monitor these symptoms closely, and consult a healthcare provider if they persist beyond two weeks: […] Lump or Mass: Often painless, a lump or swelling near joints such as the knee is the most typical sign of synovial sarcoma. […] Pain: Some people might experience pain or tenderness around the affected joint, although this is less common.

• #35 Synovial Sarcoma: What you need to know

  https://www.happiesthealth.com/articles/cancer/synovial-sarcoma

  A painless lump or swelling in the joints without previous injury should not be ignored as it can be a sign of synovial sarcoma.

• #36 Synovial Sarcoma | Memorial Sloan Kettering Cancer Center

  https://www.mskcc.org/cancer-care/types/soft-tissue-sarcoma/types/synovial-sarcoma

  Synovial sarcoma is a rare cancer that is more commonly diagnosed in people under 40. It is a form of soft tissue sarcoma. […] The main sign of synovial sarcoma is a painful lump in the arm or leg. […] The surgery thats right for you depends on the exact size and location of the tumor. […] Your doctor may also recommend radiation, chemotherapy, or other drug therapies. These treatments can help prevent the tumor from coming back. […] For synovial sarcoma that has come back after initial treatment, the soft tissue sarcoma experts at MSK may be able to offer surgery, chemotherapy, or a new treatment approach called immunotherapy.

• #37 Synovial Sarcoma on left ankle – Macmillan Online Community

  https://community.macmillan.org.uk/cancer_types/soft-tissue-sarcomas-forum/f/new-here-say-hello/260066/synovial-sarcoma-on-left-ankle

  I have now been diagnosed with Synovial Sarcoma on my ankle (change in the chromosome). […] I would guess so because 4 options have been provided and I was told I have grade 2 […] My 3-month scans have shown there is still no spread of the synovial sarcoma and my tumor has shrunk following radiation which makes a smaller area that the doctor has to excise during the operation. […] The best current standard of care for a localized tumor that has not spread (as mine was, Stage 2 intermediate grade with spindle like cells) is the wide excision surgery with radiation therapy, either before or after surgery. […] I feel very lucky thus far and, though I know it is an extended process, I feel very hopeful for a successful outcome.

• #38 Monophasic Synovial Sarcoma – Symptoms, Treatment & Support

  https://withoutaribbon.org/monophasic-synovial-sarcoma-symptoms-treatment-support/

  The patient may suffer from the following signs and symptoms. These are Usually, it can be noticed as a painless mass or lump The tumor or lump can be painful and can cause numbness if it is near the nerve. […] Surgical removal of the tumor or affected part is the main treatment option. Other treatment options are radiation therapy and chemotherapy. Radiation and chemotherapy are usually recommended in cases where the tumor has metastasized (spread of the tumor from its site of origin to distant parts of the body).

• #39 Synovial Sarcoma | UCSF Department of Surgery

  https://surgicaloncology.ucsf.edu/condition/synovial-sarcoma

  Synovial sarcoma usually presents with an otherwise asymptomatic swelling or mass, although general symptoms may be reported such as fatigue. Symptoms vary based on tumor location: […] A slow-growing painless mass is common and may give the false impression that it is harmless. When deep-seated within the body, it may go undetected. After treatment, surveillance includes regular imaging such as CT scans to detect recurrences at either the area of the original tumor or distant sites in the body (metastatic disease) such as the lungs, which are the most common site for synovial sarcoma metastases. Less than 10% of patients have detectable metastases at the time of initial diagnosis.

• #40 Explore the Synovial Sarcoma Journey | Cancer Therapy Website

  https://www.tecelra.com/the-synovial-sarcoma-journey

  Synovial sarcoma can grow slowly or the symptoms may be easy to miss, as it can present as a painless lump. […] Your prognosis, or expected outcome, can depend on many factors including tumor size, the location or depth of the tumor in the body, whether the tumor has spread to other parts of the body (metastasized), and if it can be completely removed by surgery. […] Synovial sarcoma can be slow-growing but can also be aggressive. It can metastasize (spread to other areas of the body) or come back after treatment. […] Many people try several treatments because the cancer can come back or spread.

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