The Spine Journal 16 (2016) e363–e364

Images of Spine Care

Synovial sarcoma with multiple
vertebrae metastases causing
multilevel thoracic spinal cord
compressions
A 25-year-old man with a history of synovial sarcoma of
the left knee metastatic to the lungs presented with severe back
pain. Magnetic resonance imaging of the thoracolumbar spine
demonstrated multiple vertebrae metastases with soft tissue
components causing multilevel thoracic ventral and dorsal
spinal cord compressions and pathologic vertebrae frac-
tures (Figs. 1–3).
Synovial sarcomas are soft tissue neoplasms that rarely
metastasize to the spine, and should be considered in the dif-
ferential diagnosis in patients with synovial sarcoma and
vertebra lesions.

Mustafa Kemal Demir, MD, Prof.a

Efe Fakir, Medical Studentb
Yavuz Furuncuoglu, MD, Ass. Prof.c
Süleyman Alıcı, MD, Prof.c
Andac Argon, MD, Prof.c
Sedat Koca, MD, Prof.c
a
Department of Radiology, Bahçeşehir University School of Fig. 1. Sagittal fat-saturated T2-weighted magnetic resonance imaging of
Medicine, Goztepe Medical Park Hospital, 11. kisim, the thoracic spine (Left) and lumbar (Right) spine showed multiple high signal
intensity vertebra metastases and soft tissue components, pathologic verte-
Yasemin Apt, D blok. Daire 35 Ataköy-Bakırkoy, Istanbul,
bra fractures (stars), and multilevel thoracic spinal cord compressions (arrows)
34158, Turkey caused by metastatic synovial sarcoma.
b
Bahçeşehir University School of Medicine, Goztepe
Medical Park Hospital, Çırağan Caddesi Osmanpaşa
Mektebi Sokak No: 4–6. 34353 Beşiktaş, Istanbul, Turkey
c FDA device/drug status: Not applicable.
Department of Internal Medicine, Bahçeşehir University
Author disclosures: MKD: Nothing to disclose. EF: Nothing to dis-
School of Medicine, Goztepe Medical Park Hospital, close. YF: Nothing to disclose. SA: Nothing to disclose. AA: Nothing to
Goztepe Medikal Park Hastanesi E5 Üzeri 23 Nisan Sok. disclose. SK: Nothing to disclose.
No: 17 Merdivenköy Kadıköy, Istanbul, 34732, Turkey The authors declare that they have no conflict of interest.

http://dx.doi.org/10.1016/j.spinee.2015.11.063
1529-9430/© 2015 Elsevier Inc. All rights reserved.
e364 M.K. Demir et al. / The Spine Journal 16 (2016) e363–e364

Fig. 3. Postcontrast axial fat-saturated T1-weighted magnetic resonance

imaging of the thoracic spine showed an enhancing vertebra metastasis with
soft tissue component (star) and multiple pulmonary metastases (arrows).

Fig. 2. Postcontrast sagittal fat-saturated T1-weighted magnetic resonance

imaging of the thoracic spine (Left) and lumbar spine (Right) showed en-
hancement of the metastases.