Hemiarthroplasty for Pigmented Villonodular Synovitis of the Shoulder: A Report of Two Cases

Petsatodis, George; Karataglis, Dimitrios; Kapoutsis, Dimitrios; Papadopoulos, Pericles; Christodoulou, Anastasios

doi:10.1177/230949901101900127

Cited by 9 publications

(11 citation statements)

References 20 publications

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“…Various intra-articular and extra-articular sites of origin including specific bursa locations have been identified. The knee is the most commonly affected joint, but rare cases of shoulder joint involvement have been reported [2][3][4][5]7,[9][10][11].…”

Section: Discussionmentioning

confidence: 99%

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Localized Pigmented Villonodular Synovitis of the Shoulder: A Difficult Diagnosis of a Rare Disorder

Kelly¹

2013

J Med Diagn Meth

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Introduction: Localized pigmented villonodular synovitis (LPVNS) (LPVNS) of the shoulder joint is an extremely rare disorder. It is most often associated with a nonspecific clinical presentation resulting in both delays in diagnosis and in treatment. The growth characteristics and natural history of LPVNS are poorly understood.Case report: This article describes an unusual case of a 53 -year-old woman whose treatment delay allowed us to more closely study the natural history of LPVNS. Our patient first presented with poorly localized posterior shoulder pain. Her symptoms slowly progressed. An initial MRI study more than 2 years after the onset of symptoms demonstrated a soft tissue tumor in a subscapularis recess location. Treatment with corticosteroid injections and physical therapy failed. A second MRI study, nearly 2 years later, found no change in signal characteristics, location, and size measurements of the soft tissue tumor, all important distinctions. Arthroscopic resection produced a definitive diagnosis of an intra-articular localized pigmented villonodular synovitis of the shoulder. At her final 18 mos. follow-up the patient demonstrated pain relief and no clinical recurrence of disease. Conclusion:To our knowledge, this is the first case report of a nodular appearing LPVNS arising from an intraarticular shoulder location in a patient with no prior shoulder surgery or trauma. It is also unique in that the tumor originated in a subscapularis recess location. This case documents for the first time a LPVNS with limited growth potential and emphasizes the importance of careful direct study and clinical correlation of MRI findings to avoid delays in treatment.

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Section: Discussionmentioning

confidence: 99%

“…However, benign soft tissue tumor progression about the shoulder also has consequences. The permanent erosion of bone, joint and soft tissue structures, as well as, progressive rotator cuff tears and neurovascular invasion have been documented [2][3][4][5][6][7][8][9][10][11]. The result of this destruction leads to increasing disability.…”

Section: Introductionmentioning

confidence: 99%

Localized Pigmented Villonodular Synovitis of the Shoulder: A Difficult Diagnosis of a Rare Disorder

Kelly¹

2013

J Med Diagn Meth

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“…[1][2][3][4]11 A total of 2 cases published in 1 report were treated by hemiarthroplasty with total synovectomy. 5 Recurrence of PVNS is likely due to incomplete synovectomy. Johansson et al 2 reported a recurrence rate of 33%, whereas Byers et al 6 found a 50% recurrence after total synovectomy in diffuse PVNS.…”

Section: Discussionmentioning

confidence: 99%

“…Total shoulder arthroplasty and hemiarthroplasty, in which removal of the humeral head is performed, provide better access to the joint than the more conservative approaches. 4,5 Controversy exists regarding whether hemiarthroplasty or total shoulder arthroplasty is superior for the management of glenohumeral osteoarthritis. Despite this controversy, a general consensus exists that the outcome of total shoulder arthroplasty is much better than that of hemiarthroplasty.…”

Section: Discussionmentioning

confidence: 99%

“…However, when severe bone and joint destruction is present, arthroplasty with total synovectomy is indicated. [2][3][4][5] Few reports have been published on shoulder arthroplasty as a treatment option for PVNS. This article presents the 2-year follow-up results of hemiarthroplasty in a patient with PVNS with extra-articular extension and severe bony destruction.…”

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Hemiarthroplasty in a Patient With Pigmented Villonodular Synovitis of the Shoulder

Park¹,

Park²,

Shin³

et al. 2012

Orthopedics

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We report the 2-year follow-up results of a hemiarthroplasty in a 29-year-old patient with pigmented villonodular synovitis (PVNS) with extra-articular extension and severe bony destruction. The patient presented with diffuse pain and swelling of the right shoulder for several years. Radiographs showed severe osteolytic lesions in the humeral head and neck, greater tuberosity, and a small osteolytic lesion in the glenoid neck area. Further examination with magnetic resonance imaging of the shoulder joint showed a large, lobulated soft tissue mass extending from the subdeltoid area to the chest wall invading the adjacent bony structures. The operative findings included a large, multilobulated, yellowish-brown mass extending from the subdeltoid area to the axillary pouch, subacromial space, and thoracic wall. The mass invaded the anatomical neck area of the humeral head and caused a fracture of the humeral head. We observed a complete rupture of the long head of the biceps tendon, supraspinatus tendon, and infraspinatus tendon, but the subscapularis tendon was partially ruptured. We performed the complete excision and cemented hemiarthroplasty. At 2-year follow-up, no signs of local recurrence were present. The patient had no significant pain and achieved a good functional result.To the best of our knowledge, 1 report with shoulder hemiarthroplasty in PVNS of the shoulder has been published in the English literature. For PVNS of the shoulder with a large extra-articular extension and bony destruction, shoulder arthroplasty with total synovectomy produces the lowest recurrence rates because of better access and excision to the posterior location of the PVNS lesion.

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Other Causes: Pigmented Villonodular Synovitis

Gumina

Carbone

2016

Rotator Cuff Tear

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Hemiarthroplasty for Pigmented Villonodular Synovitis of the Shoulder: A Report of Two Cases

Cited by 9 publications

References 20 publications

Localized Pigmented Villonodular Synovitis of the Shoulder: A Difficult Diagnosis of a Rare Disorder

Localized Pigmented Villonodular Synovitis of the Shoulder: A Difficult Diagnosis of a Rare Disorder

Hemiarthroplasty in a Patient With Pigmented Villonodular Synovitis of the Shoulder

Other Causes: Pigmented Villonodular Synovitis

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