Recurrence of pigmented villonodular synovitis of the knee

Fang, Yushun; Zhang, Qingsong

doi:10.1097/md.0000000000019856

Cited by 12 publications

(7 citation statements)

References 51 publications

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“…The eradication of all aberrant synovial tissue in symptomatic patients is considered a suitable treatment option for LPVNS, as it effectively relieves pain and prevents local recurrence. Nevertheless, the optimal type of resection and whether adjuvant therapy should be used remains controversial [ 27 ]. Open synovectomy is routinely performed for extraarticular extension of LPVNS when full excision cannot be achieved with an arthroscope [ 20 , 28 ].…”

Section: Discussionmentioning

confidence: 99%

“…Nevertheless, PVNS still has a certain rate of recurrence; in some cases, recurrence occurs even after 16 years postoperatively [ 35 ]. The diffuse form of the disease, incomplete resection, the lesions being located in locations difficult to access, the surgeon having limited experience and skills, and the administration of adjuvant therapy after surgery have been identified as the major risk factors for recurrence [ 27 ]. Approximately two-thirds of local recurrences are diagnosed within postoperative 2 years, while less than 10% of recurrences are found after 3 years, and it is recommended that follow-up MRI scans are performed every 6 months during the first 3 years to detect local recurrences effectively [ 36 ].…”

Section: Discussionmentioning

confidence: 99%

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Open synovectomy treatment for intra- and extraarticular localized pigmented villonodular synovitis of the knee: a case report

Wen

Zhang

et al. 2021

BMC Musculoskelet Disord

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Background Pigmented villonodular synovitis (PVNS) is a rare, benign, proliferative neoplastic process that commonly affects synovial-lined anatomic spaces. The diffuse type (DPVNS) is characterized by invasion of the entire joint synovium, while the localized type (LPVNS) is characterized by a relatively normal synovial appearance. This report describes a unique case of massive intraarticular LPVNS with an extraarticular extension through the lateral patellar retinaculum. No similar cases have been found in the literature. Case presentation A 58-year-old woman had a history of hyperuricemia and knee trauma and presented with unilateral knee acute swelling and pain symptoms with sudden onset. Recent expansion of the LPVNS caused the development of a tender palpable soft tissue mass in the anterolateral aspect of the knee and acute reduced mobility. Preoperative magnetic resonance imaging of the knee revealed the presence of only the soft tissue mass and mild degenerative changes. Open synovectomy was performed successfully to excise the mass. Intraoperatively, macroscopic features of the bright brown inflamed synovium suggested LPVNS, which was confirmed histopathologically. Postoperatively, the symptoms of limited mobility and pain were appreciably relieved. Recurrence was not observed during the clinical follow-up at 1, 6 or 18 months after surgery. Conclusions Here, we report the unique case of localized pigmented villonodular synovitis of the knee in a misdiagnosed patient with intra- and extraarticular lesion, which might be attributed to the history of knee trauma and the focal defect of the lateral patellar retinaculum. Open synovectomy effectively relieved the symptoms of limited mobility and pain and no recurrence was observed prior to 18 months postoperatively. To reduce misdiagnosis, MRI examinations are recommended for all patients suspected of having PVNS, including those who have a history of hyperuricemia.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Open synovectomy treatment for intra- and extraarticular localized pigmented villonodular synovitis of the knee: a case report

Wen

Zhang

et al. 2021

BMC Musculoskelet Disord

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“…43 Radiotherapy alone can be used as the primary treatment for intraarticular diffuse TGCT, but it is best if used as a supplement of surgical treatment to control an incomplete resection and/or recurrence. 7,43 Several studies have shown that using radiation is linked to lower recurrence rates than the rates associated with a surgical procedure alone. 40 Radiation is administered using an external beam with doses of 20 to 50 Gy, which are supplied in 15 to 25 fractions, starting with the period of 6 to 8 weeks following the surgery.…”

Section: Treatment and Prognosismentioning

confidence: 99%

“…When a surgical resection alone is not sufficient or is not possible, simultaneous additional therapy is recommended for patients with risk factors of recurrence. 43…”

Section: Tenosynovial Giant Cell Tumormentioning

confidence: 99%

Giant Cell Tumor of Bone Versus Tenosynovial Giant Cell Tumor – Similarities and Differences

2022

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Giant cell tumor of bone (GCTB) and tenosynovial giant cell tumor (TGCT) share misleadingly similar names, soft texture and brown color macroscopically, osteoclast-like multinucleated giant cells microscopically and localisation in the musculoskeletal system. However, these two tumor types are biologically and clinically two distinct entities with different natural courses of progression and considerably different modes of surgical and medical treatment. In this article, we provide a detailed update on the similarities and the differences between both tumor types. GCTB is a locally aggressive osteolytic bone tumor, commonly seen in patients in their third decade of life. It usually occurs as a solitary lesion in the meta-epiphyseal region of long bones. It can be diagnosed using plain radiographic imaging, CT radiography or MRI to estimate the tumor extent, soft tissue and joint involvement. GCTB is usually treated with intralesional excision by curettage. Systemically, it can be treated with bisphosphonates and denosumab or radiotherapy. TGCT is a rare, slowly progressing tumor of synovial tissue, affecting the joint, tendon sheath or bursa, mostly seen in middle-aged patients. TGCT is usually not visible on radiographs and MRI is mostly used to enable assessment of potential bone involvement and distinguishing between two TGCT types. Localised TGCT is mostly treated with marginal surgical resection, while diffuse TGCT is optimally treated with total synovectomy and is more difficult to remove. Additionally, radiotherapy, intraarticular injection of radioactive isotopes, anti-TNF-α antibodies and targeted medications may be used.

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“…МЕДИЧНІ НАУКИ ТА ГРОМАДСЬКЕ ЗДОРОВ'Я Вступ. Пігментний віллонодулярний синовіт (ПВНС) і теносиновіальну гігантоклітинну пухлину вважають одним і тим самим захворюванням через однакові гістологічні та генетичні особливості [1,2]. Протягом тривалого часу обговорюють етіологію та патогенез пігментного віллонодулярного синовіту.…”

unclassified

Роль Дистанційної Променевої Терапії В Лікуванні Хворих На Пігментний Віллонодулярний Синовіт Колінного Суглоба

et al. 2021

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Пігментний віллонодулярний синовіт (ПВНС) і теносиновіальну гігантоклітинну пухлину вважають одним і тим самим захворюванням через однакові гістологічні та генетичні особливості. Протягом тривалого часу обговорюють етіологію та патогенез пігментного віллонодулярного синовіту. Стандартним методом лікування хворих на ПВНС є хірургічне видалення ураженої захворюванням оболонки. Ад'ювантна терапія розглядається як альтернативний метод лікування. Застосування разової опромінюючої дози у 2,0 Гр, та підведеної сумарної опромінюючої дози за курс лікування у 30,0 Гр є оптимальними для досягнення хороших результатів лікування дифузної форми пігментного віллонодулярного синовіту колінного суглоба.

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Recurrence of pigmented villonodular synovitis of the knee

Cited by 12 publications

References 51 publications

Open synovectomy treatment for intra- and extraarticular localized pigmented villonodular synovitis of the knee: a case report

Open synovectomy treatment for intra- and extraarticular localized pigmented villonodular synovitis of the knee: a case report

Giant Cell Tumor of Bone Versus Tenosynovial Giant Cell Tumor – Similarities and Differences

Роль Дистанційної Променевої Терапії В Лікуванні Хворих На Пігментний Віллонодулярний Синовіт Колінного Суглоба

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