The Imaging Spectrum of Synovial Sarcomas: A Pictorial Review From a Single-Centre Tertiary Referral Institution

Abstract

Synovial sarcomas are malignant soft-tissue tumors that typically affect young patients. They can arise from nearly anywhere in the body, most commonly the extremities, head and neck, and thorax. The imaging features are highly variable and depend on the anatomic origin. Most lesions present as large aggressive heterogeneous masses containing hemorrhagic and cystic foci, often with calcification. However, up to one-third of lesions have commonly benign features and can appear homogeneously solid or cystic. Especially in these cases, their innocuous imaging and clinical presentation can lead to delayed diagnosis. Therefore, knowledge of the imaging spectrum is crucial to ensuring adequate follow-up or timely pathologic sampling. We reviewed 30 pathologically proven cases in various anatomic sites from our institution to illustrate these characteristics.