Title: Synovial sarcoma of the limbs: clinical features, imaging, and treatment- A retrospective study of 19 cases
Authors: Dr OMAR HABIB ALLAH, Dr AYOUB MIKOU, Pr MOHAMMED BENSAKA, Pr HATIM ABID, Pr MOHAMMED ELIDRISSI, Pr ABDELMAJID ELMRINI
Volume: 10
Issue: 9
Pages: 150-156
Publication Date: 2026/09/28
Abstract:
Synovial sarcoma (SS) is a rare malignant soft tissue tumor of mesenchymal origin with variable epithelial differentiation, accounting for 5-10% of all soft tissue sarcomas. It carries a reputation for diagnostic difficulty and a guarded long-term prognosis. We conducted a retrospective descriptive study of 19 cases of limb synovial sarcoma managed in the Department of Traumatology and Orthopedic Surgery B4 at CHU Hassan II, Fes, Morocco, between January 2020 and December 2025. The mean patient age was 36.68 years (range: 17-77), with a male predominance (M/F = 1.7). Lower limb localization predominated (79%), particularly the thigh (32%). The mean diagnostic delay was 18 months, reflecting the indolent and nonspecific clinical presentation of this tumor. MRI was performed in 84% of patients and constituted the reference imaging modality. Histological confirmation was achieved in all cases, primarily through surgical biopsy (52.5%). Surgical resection was the cornerstone of treatment: limb-sparing surgery was feasible in 56% of patients, while 44% required amputation or disarticulation due to locally advanced disease. Chemotherapy was administered in 63% of cases and adjuvant radiotherapy in 15.7%. Local recurrence was observed in 26.3% and distant metastases in 58% of patients, predominantly pulmonary. The overall mortality rate reached 31.5%. Our series confirms the aggressive biological behavior of SS and underscores the necessity of early diagnosis, rigorous staging, and coordinated multidisciplinary oncological management.