Abstract
ABSTRACTObjectives Several cases of bilateral diffuse pigmented villonodular synovitis (PVNS) or tenosynovial giant cell tumor have been described in the literature. Nevertheless, some presentations are rare and differential diagnoses are necessary.Methods The purpose of this study was to perform a systematic review of the literature related to PVNS and to report a rare supra-patellar bilateral and focal presentation. We performed a systematic data review in the Pubmed Clinical Queries database using MeSH and keywords related to PVNS and tenosynovial giant cell tumor.Results Two cases of bilateral and local PVNS had been previously described, but neither was localized in the supra-patellar compartment. To our knowledge, this case report is the first to describe supra-patellar bilateral and localized PVNS of the knee. This case involves a 28 -year-old woman with bilateral localized PVNS of the supra-patellar recess of the knee. MRI showed a low-signal intensity nodule in T1- and T2-weighted images. These were associated with hemosiderin pigmentation.Conclusion The most important finding of the case reported is related to rarity and location. Histopathology analysis confirmed a rare case of hemosiderin pigmentation in the capsular nodule with internal non-pigmented villous content. Lipoma arborescens in the supra-patellar form must be ruled out as a differential diagnosis since it occurs in the same site. Level of Evidence IV; Case series.
Highlights
Pigmented villonodular synovitis (PVNS) is a proliferative and inflammatory disease with benign outcome.[1]
Several cases of bilateral diffuse pigmented villonodular synovitis (PVNS) or tenosynovial giant cell tumor have been described in the literature
The purpose of this study was to perform a systematic review of literature related to localized pigmented villonodular synovitis reports about the knee and to present a rare supra-patellar bilateral and focal example
Summary
Pigmented villonodular synovitis (PVNS) is a proliferative and inflammatory disease with benign outcome.[1] PVNS presents either in a localized form, with minimal rates of recurrence after surgical resection, or in a diffuse form, with an expansive growth pattern showing formation of osseous erosions and extra-articular manifestation. In the diffuse form, high recurrence rates occur due to total synovectomy. Only one single joint, the knee in 80% of cases, is involved with diffuse PVNS. Reports of bi- or multiarticular manifestation are rare.[1]. All authors declare no potential conflict of interest related to this article
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