The Orthobullets Podcast Pathology | Synovial Sarcoma
Sep 6, 2025
Dive deep into the world of synovial sarcoma, a rare cancer affecting young adults. Learn about its prevalence, causes, and unique manifestations. Explore the fascinating genetic factors and the latest diagnostic techniques. Gain insights into the aggressive nature of the disease and current treatment strategies. Delve into the histology of its monophasic and biphasic forms, unraveling misconceptions about the SYT-SSX fusion protein and its impact on prognosis.
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Genetic Driver And Typical Presentation
- Synovial sarcoma is a malignant soft-tissue tumor linked to an X;18 translocation producing SYT-SSX fusion proteins.
- It most often arises near joints in patients aged 15–40 and requires biopsy for diagnosis.
Name Is Misleading; Fusion Is Key
- The cellular origin is unknown and the name 'synovial' is a misnomer.
- Over 90% of cases harbor an X;18 translocation forming SYT-SSX1, SSX2, or rarely SSX4 fusion proteins.
Metastatic Patterns And Prognostic Implications
- Metastasis occurs in 30–60% of patients, most commonly to the lungs.
- Synovial sarcoma is one of few sarcomas that can metastasize to lymph nodes, which worsens prognosis but is less dire than lung metastasis.