Pigmented villonodular synovitis and giant cell tumors of the tendon sheath: radiologic and pathologic features.

Llauger, Jaume; Palmer, J.; Roson, N.; Cremades, Rosa; Bagué, Sílvia

doi:10.2214/ajr.172.4.10587152

Cited by 107 publications

(91 citation statements)

References 11 publications

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“…The clinical manifestations of D-GCTS are local swelling, limitation of movement and joint closure (19). The incidence of D-GCTS is observed more often in female patients compared with male patients (4,5).…”

Section: Discussionmentioning

confidence: 99%

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Diffuse-type giant cell tumor of the tendon sheath in the temporal region incidentally diagnosed due to a temporal tumor: A report of two cases and review of the literature

Qin

Jin

et al. 2015

Oncology Letters

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Abstract. Diffuse-type tenosynovial giant cell tumor (D-GCTS) is a rare benign lesion that not only frequently occurs in the fingers, but also along the tendon sheaths of the foot and ankle. The present study reports the cases of two middle-aged patients that were diagnosed with D-GCTS. The presentation of the D-GCTS lesions was extremely rare, as the tumors were located in the temporal fossa and threatened the skull base and external auditory canal. There were similarities and differences between the two patients in their clinical symptoms, disease progressions and invading sites. The patients' disease course occurred unnoticed with the absence of pain, was protracted and became infiltrative. However, the female patient was admitted to the hospital due to the occurrence of pain in the left temporal region, and the male patient presented at the doctor due to a painless left temporal mass and external auditory canal bleeding. Therefore, the operation area of the two patients was not the same. This type of illness should be considered in the differential diagnosis for masses occurring in the temporal region. Total tumor removal is the best treatment for D-GCTS, and the careful monitoring of recurrence can achieve a good clinical outcome subsequent to the surgical resection. IntroductionGiant cell tumor of the tendon sheath (GCTS) was initially described by Chassaignac in 1852 (1), and the lesion was defined as a malignant tumor at that time (2). Subsequently, Heurteux produced a detailed description of GCTS (3). It was found that the disease occurs more frequently in middle-aged women compared with men (4). According to the position (large or facet joint; intra-or extra-articular), characteristics (benign or malignant) and growth pattern (diffuse or localized) of the tumor, GCTS may be classified as one of four types: Localized-type tenosynovial giant cell tumor (L-GCTS); diffuse-type tenosynovial giant cell tumor (D-GCTS); pigmented villonodular synovitis (PVNS) (5,6); and malignant tenosynovial giant cell tumor (M-GCTS) (7,8).D-GCTS demonstrates invasive growth in the local region, which is considerably different from L-GCTS. D-GCTS usually develops in the synovium, and often invades the surrounding knee and soft tissue (2,9). Since it arises mainly from the soft tissue outside the joints, Weiss et al (10) regarded D-GCTS as a type of PVNS that appears in the soft tissue outside the joints, and also presents with intra-articular lesions (2,5). L-GCTS mainly occurs in the small joints, including the hand, foot and ankle. Image findings in previous studies reveal these soft tissue masses occur beside small joints (9,11). If the results of image analysis demonstrate that the lesions have invaded the joints, and if there is a concurrent weak signal of T1W and T2W on a magnetic resonance imaging (MRI) scan, D-GCTS should be considered as a probable diagnosis (12-15).GCTS usually occurs in individuals between the ages of 30 and 50 years (5). As a painless and slow-growing disease, it has been termed an innocent tumor ...

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Section: Discussionmentioning

confidence: 99%

“…MRI can reveal the diffuse and invasive growth of the irregular mass lesion adjacent to the joints, the origin and scope of the lesions, and the level of intra-articular invasion. Generally the MRI signal is weak and this is one of the characteristics of the imaging diagnosis of D-GCTS (12,19,21).…”

Section: Discussionmentioning

confidence: 99%

Diffuse-type giant cell tumor of the tendon sheath in the temporal region incidentally diagnosed due to a temporal tumor: A report of two cases and review of the literature

Qin

Jin

et al. 2015

Oncology Letters

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“…Although some uncertainty remains concerning its histiogenesis, karyotypic abnormalities isolated in GCTTS cells have largely been accepted as evidence of a neoplastic phenomenon [20]. GCTTS is the second most common soft tissue neoplasm of the hand, surpassed in incidence only by ganglion cysts [10,13,16,18,26]. It is a benign proliferative lesion of synovial origin that occurs most commonly in the hand and fingers [18], typically throughout the third through fifth decades of life [10], and it shows a slight female preponderance [10,13,18].…”

Section: Discussion and Treatmentmentioning

confidence: 99%

“…GCTTS is the second most common soft tissue neoplasm of the hand, surpassed in incidence only by ganglion cysts [10,13,16,18,26]. It is a benign proliferative lesion of synovial origin that occurs most commonly in the hand and fingers [18], typically throughout the third through fifth decades of life [10], and it shows a slight female preponderance [10,13,18]. Left untreated, the lesion may undergo a rapid increase in size, cause pain with movement, or impair normal function [22].…”

Section: Discussion and Treatmentmentioning

confidence: 99%

Orthopaedic Case of the Month: A 51-year-old Man with a Painless Wrist Mass

Nicolescu

Clifford

Robinson

et al. 2013

Clinical Orthopaedics &Amp; Related Research

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A 51-year-old right-hand dominant man was evaluated for an enlarging, painless left wrist mass of 2 months duration. The patient reported no recent injury or antecedent trauma and denied any local neurologic symptoms, fevers, chills, or changes in weight.Physical examination revealed a nontender, 3 9 2-cm firm, mobile mass overlying the volar aspect of the left distal ulna. There was no rash or other identifiable overlying skin changes, and the lesion did not transilluminate. The patient had normal strength and ROM, and sensation to light touch was intact in all three nerve distributions. There was a negative Tinel's sign and the mass was nonpulsatile with a normal vascular examination.AP and lateral views of the left wrist ( Fig. 1) and MRI of the wrist (Fig. 2) were obtained.

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“…The etiology of PVNS remains controversial but degenerative change and trauma have been implicated [1, 2, 6, 9, 11-14, 20, 31]. It is well known that PVNS occurs in young individuals and affects the appendicular skeleton, particularly the knee and hip joints [2,9,16,18,19,22,23,28]. The occurrence of PVNS in the axial skeleton is quite rare and there have been few reports of PVNS of the lumbar spine; specifically, only 18 cases are found in the English literature [4,7,8,10,16,21,23,24,26,27,30,31].…”

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confidence: 99%

Pigmented villonodular synovitis originating from the lumbar facet joint: a case report

Sasai

Yoshida

et al. 2007

Eur Spine J

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The authors successfully treated a rare case of pigmented villonodular synovitis (PVNS) that originated from the lumbar facet joint (L4-5). A 43-year-old man presented with a complaint of left severe sciatica causing difficulty in walking. Magnetic resonance imaging (MRI) demonstrated an extradural mass on the left side at L4 and the mass compressed the dural tube and was continuous with the left L4-5 facet joint. A computed tomography myelogram revealed an extradural defect of contrast medium at the L4 level and an erosion of the L4 lamina. A total synovectomy with unilateral osteoplastic laminectomy was performed. The histological findings were a diagnosis of PVNS. The patient's symptoms resolved completely and the MRI at postoperative 3 years demonstrated no recurrence of PVNS. It is important to totally remove the synovium, which is the origin of PVNS in order to prevent the recurrence. We think that our procedure is reasonable and adequate for lumbar PVNS.Keywords Pigmented villonodular synovitis Á Lumbar spine Á Synovectomy Á Juxtafacet cyst Á Laminoplasty Pigmented villonodular synovitis (PVNS) is a slowly progressive mass lesion that arises in association with villous or nodular overgrowth in the synovial membranes of tendon sheaths, joints and bursae [12,14,31]. The etiology of PVNS remains controversial but degenerative change and trauma have been implicated [1, 2, 6, 9, 11-14, 20, 31]. It is well known that PVNS occurs in young individuals and affects the appendicular skeleton, particularly the knee and hip joints [2,9,16,18,19,22,23,28]. The occurrence of PVNS in the axial skeleton is quite rare and there have been few reports of PVNS of the lumbar spine; specifically, only 18 cases are found in the English literature [4,7,8,10,16,21,23,24,26,27,30,31]. There have been no reports focusing on surgical treatment for PVNS although it is important that the synovium is totally removed to prevent the recurrence [5]. We successfully treated a case of PVNS that originated from the lumbar facet joint (L4-5) using total synovectomy with unilateral osteoplastic laminectomy. Case reportA 43-year-old man presented with a 2-year history of low back pain and he had undergone conservative medical treatment with a diagnosis of L5 spondylolysis. He consulted us with a complaint of left severe sciatica causing difficulty in walking for 3 weeks. He had no obvious history of trauma. Neurological examination revealed normal deep tendon reflexes in the lower legs bilaterally (patellar tendon reflex and Achilles tendon reflex) and a negative result upon performing the straight leg raising test. There were no sensory disturbances, motor weakness or urinary incontinence. Plain lumbar spine radiographs showed spondylolysis and anterolisthesis of L5. Magnetic resonance imaging (MRI) demonstrated an extradural mass on the left side at L4. This mass lesion showed mixed high and iso-intensity on T1-weighted imaging, and mixed high and

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Pigmented villonodular synovitis and giant cell tumors of the tendon sheath: radiologic and pathologic features.

Cited by 107 publications

References 11 publications

Diffuse-type giant cell tumor of the tendon sheath in the temporal region incidentally diagnosed due to a temporal tumor: A report of two cases and review of the literature

Diffuse-type giant cell tumor of the tendon sheath in the temporal region incidentally diagnosed due to a temporal tumor: A report of two cases and review of the literature

Orthopaedic Case of the Month: A 51-year-old Man with a Painless Wrist Mass

Pigmented villonodular synovitis originating from the lumbar facet joint: a case report

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