Introduction and Objectives: Synovial sarcoma is an infrequent mesenchymal neoplasia (between 8–10% of soft tissue sarcomas) that can originate in the joint capsule, bursa and tendon sheaths.

Materials and Methods: We studied 52 cases of synovial sarcomas reviewed between 1983 and 2006, with a mean follow-up of 91.4 months (24–204 months). The mean age of the patients was 38.4 years of age (range 13–86). The most frequent location was the knee and the popliteal area. In 25 cases a wide resection was performed and in 17 cases amputation was carried out. The most frequently used treatment protocol was preoperative chemotherapy plus postoperative chemo and radiotherapy. In one of the recurrence cases isolated perfusion of the limb was performed due to a recurrence of synovial sarcoma in a hand.

Results: One or more recurrences during follow-up were seen in 24 patients. There were 2 cases (3.8%) of skin and cervical spine metastasis and 20 cases of lung metastasis. Eleven patients died (19%). The survival rate at 5 years was 61%.

Discussion and Conclusions: Synovial sarcoma is the third most frequent soft tissue sarcoma. It is an aggressive entity, with a high recurrence rate and considerable mortality. When it is not possible to achieve safe margins the ideal treatment is a wide resection or amputation. Neoadjuvant or adjuvant therapies have an important role in treatment. Treatment by a multidisciplinary team is indispensable to improve survival rates.