Multifocal pigmented villonodular synovitis in a child

Zhao, Liang; Zhou, Kaiyu; Hua, Yimin; Li, Yifei; Mu, Dezhi

doi:10.1097/md.0000000000004572

Cited by 16 publications

(26 citation statements)

References 14 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…We found in the literature a total of 33 studies involving <40 case reports associated with shoulder PVNS. However, only three cases were associated with the occurrence of the disease in minors, one of them in a child [ 6 ] and two others in adolescents [ 3 , 7 ]. We did not find any reports specifying exclusive involvement of the subacromial bursa.…”

Section: Discussionmentioning

confidence: 99%

Subacromial pigmented villonodular synovitis: case report and review

Pereira

Baldan

Andreoli

et al. 2021

Journal of Surgical Case Reports

View full text Add to dashboard Cite

Pigmented villonodular synovitis (PVNS) is a non-neoplastic proliferative process that involves synovial tissue in the joints, tendon sheaths and bursae. It usually occurs in young adults, aged 20–50 years, is characteristically monoarticular and of slow progression. Clinical symptoms are nonspecific, and joint stiffness and pain are common in long-term cases. Shoulder PVNS is known to be extremely rare, especially when affecting the subacromial bursal region without joint involvement. Magnetic resonance is the imaging modality of choice in PVNS and is useful for diagnosis, surgical planning and monitoring. Complete surgical synovectomy remains the treatment of choice, and all pathological synovial tissue should be removed. Patients who are not properly treated can progress to joint destruction. We describe a case of PVNS in the subacromial bursa of a 15-year-old patient, with exuberant symptoms and 2 years of evolution, treated with extensive synovectomy and good clinical results in the 1-year follow-up.

show abstract

Section: Discussionmentioning

confidence: 99%

Subacromial pigmented villonodular synovitis: case report and review

Pereira

Baldan

Andreoli

et al. 2021

Journal of Surgical Case Reports

View full text Add to dashboard Cite

show abstract

“…It is a rare, sarcomalike, benign disease, and its incidence is about 1.8 cases per million people [1,2,3]. Younger patients seem to be predominantly affected, and the incidence peaks at the age of 30 to 40 years [3].…”

Section: Introductionmentioning

confidence: 99%

“…Pigmented villonodular synovitis (PVNS) is a mono-articular proliferative process that originates from the synovial membranes and is also characterized by articular cartilage invasion. It is a rare, sarcomalike, benign disease, and its incidence is about 1.8 cases per million people [1,2,3]. Younger patients seem to be predominantly affected, and the incidence peaks at the age of 30 to 40 years [3].…”

Section: Introductionmentioning

confidence: 99%

Long-term functional outcomes of diffuse pigmented villonodular synovitis of the knee after synovectomy with or without adjuvant radiotherapy

Chien¹,

Wei²,

Chen³

et al. 2020

Preprint

View full text Add to dashboard Cite

Background Diffuse pigmented villonodular synovitis (PVNS) of the knee is a rare benign disease that has a destructive clinical course. Reported treatment options include arthroscopic or open synovectomy with or without adjuvant radiotherapy of various doses. This study compared the long-term functional outcomes and disease control among treatment modalities and discussed 22 years of experience with radiotherapy (RT) as an adjuvant treatment for PVNS of knee.Methods A single-center database was searched for patients who received synovectomy of knee with the pathologic diagnosis of PVNS. General data, treatment modalities, and recurrent status were retrospectively collected from medical records. Functional outcomes were evaluated by Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) through phone interviews by an independent orthopedist.Results From January 1995 to December 2017, 24 patients with diffuse PVNS of knee were identified, including 19 receiving open synovectomy (OP) and 5 undergoing arthroscopic surgery (AS). Adjuvant RT was performed on 14 patients with a median dose of 34.25 Gy (range 20-40 Gy). After median follow up of 6 years, clinically or radiographically confirmed recurrences were recorded in 10 cases. The local recurrence rate was significantly lower in the OP+RT group than the OP group (8.3% vs. 57.1%, p =0.038). Among those with preserved knee joints, there was no significant difference in the WOMAC score and stiffness score between patients in the OP+RT and OP groups.Conclusions In conclusion, for patients with diffuse PVNS of knee, the addition of moderate-dose adjuvant RT to open synovectomy provided excellent local control while maintaining good joint function with limited treatment-related morbidity. Our study emphasized the importance of moderate dose of RT in diffuse PVNS of knee joint.

show abstract

“…[ 1 ] Typically, PVNS is almost always monoarticular, while multiarticular disease in children have been reported. [ 2 ] Although it is classified as a benign condition, it has local invasiveness. Untreated PVNS can rapidly lead to irreversible joint destruction.…”

Section: Introductionmentioning

confidence: 99%

Necessity of adjuvant postoperative radiotherapy for diffuse pigmented villonodular synovitis of the knee

et al. 2018

View full text Add to dashboard Cite

Rationale:Pigmented villonodular synovitis (PVNS) is an idiopathic, proliferative disorder lesion of synovial tissue, which is regarded as a benign disease, but has a local invasion. Up to now, these are no consensus about the etiology and pathogenesis of PVNS. Because of the lack of typical clinical features, misdiagnosis and delayed diagnosis are not uncommon, magnetic resonance imaging (MRI) can assist diagnosis and histopathological examination is recognized as the gold standard for the final diagnosis. Because this disease is so rare, there is no standard treatment. Surgical resection of the lesion is considered the preferred treatment, but postoperative recurrence is a problem that cannot be ignored. Postoperative radiotherapy is necessary, especially for patients with diffuse PVNS of the knee.Patient concerns:A 27-year-old female teacher presented with 3 years chronic pain of the right knee, and progressive swelling aggravated for 1 week. The range of motion of the knee was limited.Diagnoses:Clinical and laboratory examination failed to provide definitive diagnosis. Imaging can assist in diagnosis, and pathology is the gold standard. Erythrocyte sedimentation rate (ESR), antihemolytic streptococcus O (ASO), and rheumatoid factors (RF) were all negative. Joint puncture revealed giant cell tumor of the synovial membrane. PVNS was confirmed by postoperative pathology. The characteristic T2 weighted low signal of MRI suggests the recurrence of PVNS.Interventions:The patient underwent 2 stages of treatment: open synovectomy was performed in the first place and postoperative external radiotherapy was not considered. After 2 years of disease-free remission, she was diagnosed with a recurrence of the disease by MRI. Further, arthroscopic total synovectomy of the right knee was performed and external beam radiotherapy was carried out after the operation.Outcomes:Up to now, the patient was followed up for 3 years without any sign of recurrence.Lessons:Adjuvant postoperative radiotherapy can improve the local control rate, it is a reliable treatment method for diffused PVNS.

show abstract

Multifocal pigmented villonodular synovitis in a child

Cited by 16 publications

References 14 publications

Subacromial pigmented villonodular synovitis: case report and review

Subacromial pigmented villonodular synovitis: case report and review

Long-term functional outcomes of diffuse pigmented villonodular synovitis of the knee after synovectomy with or without adjuvant radiotherapy

Necessity of adjuvant postoperative radiotherapy for diffuse pigmented villonodular synovitis of the knee

Contact Info

Product

Resources

About