Prognostic factors of the synovial sarcoma of the extremities: imaging does matter

General Commentary: Synovial sarcoma of the head and neck: A review of reported cases on the clinical characteristics and treatment methods

“…Considering these points, one case in which only biopsy results were reported would have had to be excluded from the review by Quan et al (2022). Although characteristic imaging features of SS have been reported, including calcification (via CT) and the triple sign and pseudo-cystic sign (via magnetic resonance imaging), those results had relatively low sensitivity (Tordjman et al, 2023). However, those imaging features were useful for surgical planning.…”

Responding to “Chronic thigh pain in a young adult diagnosed as synovial sarcoma: A case report” by Dr Chambers and Lesher

“…2 The average tumor size in typical cases is relatively small, at 3 to 10 cm; tumor size is a prognostic factor for overall survival. 2,3 In some cases of SS of the hands and feet, the tumor diameters have been <1 cm. 2 Such findings indicate the presence of benign tumors.…”

“…2 The presence of calcification is correlated with good prognosis. 3 However, calcification of schwannoma is extremely rare, with scattered distribution in punctate, mottled, or curvilinear pattern. 5 On radiographic examination of the patient's lesion, 1 the calcification pattern seemed to be similar to that of SS.…”

“…3 Among these, the pseudo-cystic sign is associated with local recurrence. 3 The tail sign is often seen in sarcomas including SS and reflects infiltrative ability. 3 In fact, on MRI, the tail sign is visible on the lateral side along the fascia.…”

“…3 The tail sign is often seen in sarcomas including SS and reflects infiltrative ability. 3 In fact, on MRI, the tail sign is visible on the lateral side along the fascia. Meanwhile, the target sign and split sign are characteristic findings of schwannoma, 5 but there were no such findings in this case.…”