The current retrospective study examined a relatively large group of synovial sarcoma patients of all ages who were evaluated at a single institution over a 21 year period.
There were 42 females and 40 males, whose age ranged from 13 to 75 (median 34 years). The neoplasms measured from 1,5 to 24 cm in greatest diameter (median 8,5 cm). Tumor locations were as follows; lower extremities (53 cases), upper extremities (16 cases), trunk (7 cases) and head-neck (3 cases).
One hundred thirty six material belonging to 82 cases were evaluated histologically. Of these cases, 58 were monophasic fibrous type, 18 were biphasic type and 6 were poorly differentiated type synovial sarcoma. Immunohistochemically, monophasic fibrous type and poorly differentiated type synovial sarcoma cases (64 cases) were positive for EMA or cytokeratin. Of these cases, 14 were EMA positive but cytokeratin negative, however six were cytokeratin positive but EMA negative.
Follow up was available for 43 patients with a duration of median 47 months. Of the 43 patients, 12 died of disease, nine had metastatic disease, nine had local reccurence and 13 (30%) had no evidence of disease.
In conclusion, synovial sarcoma is an aggressive neoplasm and is affected from radiochemotherapy in varying proportions. Most of the synovial sarcoma cases can be diagnosed by the help of morphology and immunohistochemistry (by applying both EMA and cytokeratin).