Synovial sarcoma presenting as an avascular mass: Radiologic-pathologic correlation

Ann E. McCullough, Adam J. Schwartz, Veronica L. Taylor, Mark J. Kransdorf

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Synovial sarcoma is a well-recognized soft tissue malignancy that typically arises in young adults. It is now generally accepted that its origin is likely from undifferentiated mesenchymal tissue with variable epithelial differentiation and a highly specific chromosomal translocation in more than 95% of cases. The lesion typically presents as a slow-growing soft tissue mass, with MR imaging demonstrating a heterogeneous mass with variable amounts of low-, intermediate- and high-signal intensity on fluid-sensitive images and prominent heterogeneous enhancement, reflecting its vascularity. The relative hypervascularity of synovial sarcoma has been well established and is reflected in its enhancement on MR imaging studies. Contrast enhancement on MR imaging has been long used as a marker for tissue vascularization and perfusion, with malignant lesions generally being more vascular and enhancing more rapidly. We recently encountered a patient with a high-grade synovial sarcoma with no discernable necrosis and no vascularity on contrast-enhanced MR images with the subtraction technique, despite enhancement in adjacent regional metastatic lymph nodes. The pathologic basis for this unusual imaging appearance was a paucity of small-caliber vessels within the sarcoma due to extensive hyalinization of the mass.

Original languageEnglish (US)
Pages (from-to)279-284
Number of pages6
JournalSkeletal Radiology
Volume44
Issue number2
DOIs
StatePublished - 2015

Fingerprint

Synovial Sarcoma
Subtraction Technique
Genetic Translocation
Sarcoma
Blood Vessels
Young Adult
Necrosis
Perfusion
Lymph Nodes
Neoplasms

Keywords

  • Avascular
  • Metastases
  • MRI
  • PET
  • Soft tissue
  • Subtraction MRI
  • Synovial sarcoma

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

McCullough, A. E., Schwartz, A. J., Taylor, V. L., & Kransdorf, M. J. (2015). Synovial sarcoma presenting as an avascular mass: Radiologic-pathologic correlation. Skeletal Radiology, 44(2), 279-284. https://doi.org/10.1007/s00256-014-1964-9

Synovial sarcoma presenting as an avascular mass : Radiologic-pathologic correlation. / McCullough, Ann E.; Schwartz, Adam J.; Taylor, Veronica L.; Kransdorf, Mark J.

In: Skeletal Radiology, Vol. 44, No. 2, 2015, p. 279-284.

Research output: Contribution to journalArticle

McCullough, AE, Schwartz, AJ, Taylor, VL & Kransdorf, MJ 2015, 'Synovial sarcoma presenting as an avascular mass: Radiologic-pathologic correlation', Skeletal Radiology, vol. 44, no. 2, pp. 279-284. https://doi.org/10.1007/s00256-014-1964-9
McCullough, Ann E. ; Schwartz, Adam J. ; Taylor, Veronica L. ; Kransdorf, Mark J. / Synovial sarcoma presenting as an avascular mass : Radiologic-pathologic correlation. In: Skeletal Radiology. 2015 ; Vol. 44, No. 2. pp. 279-284.
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