Extra-articular Pigmented Villonodular Synovitis Research Articles

Extra-Articular Pigmented Villonodular Synovitis of the Deep Infrapatellar Bursa: A Case Report.

Pigmented villonodular synovitis is a rare, benign, proliferative neoplastic condition affecting synovial-lined anatomic spaces1,2. It is characterized by hypertrophy of a synovial membrane by villous, nodular, and villonodular proliferation, with pigmentation secondary to hemosiderin deposition. These characteristics result in its typical imaging findings of low signal intensity on both T1 and T2-weighted images and typical “blooming artifact” with loss of signal foci on gradient echo sequences3-5. It is now well established in the pathology literature that pigmented villonodular synovitis is a neoplastic process on the basis of characteristic chromosomal changes6-9. Pigmented villonodular synovitis can be both localized and diffuse10 and can affect all synovial membranes, such as those of the joint or the bursa. For both forms of the disease, simple debridement with synovectomy is the most common treatment, although recurrence is common11—with rates as high as 25% to 50% in diffuse-type extra-articular disease12. Pigmented villonodular synovitis is usually monoarticular, affecting adults in the third or fourth decade of life; the knee is the most commonly involved anatomic location, followed by the hip, ankle, shoulder, and elbow13. Pigmented villonodular synovitis is usually intra-articular and only rarely extra-articular. In cases of extra-articular pigmented villonodular synovitis, there is usually evidence of extension from an intra-articular focus. As a result, the finding of pigmented villonodular synovitis in the deep infrapatellar bursa, which does not communicate with the knee joint14,15, is rare. Furthermore, to the best of our knowledge, there has never been a report of pigmented villonodular synovitis in the deep infrapatellar bursa. We present a case of extra-articular pigmented villonodular synovitis in a young patient with a painful slow-growing mass on the anterior aspect of the knee. The patient …

Détection fortuite d’une synovite villonodulaire extra-articulaire du muscle psoas en tomographie par émission de positons au 18F-fluorodésoxyglucose

Pigmented villonodular synovitis (PVNS) is a benign but locally aggressive disorder, which commonly involves large joints. This article reports a rare case of an extra-articular PVNS located within the left psoas muscle. This lesion has been accidentally discovered during a follow-up FDG PET/CT. The patient was asymptomatic and did not undergo any surgery. This article reports that FDG PET/CT could be helpful for monitoring PVNS.

Pigmented Villonodular Synovitis of the Temporomandibular Joint

Pigmented villonodular synovitis (PVNS) is a proliferative disorder that affects synovium-lined joints, bursae, and tendon sheaths. It appears in both diffuse and localized forms, depending on the extent of synovial involvement. PVNS rarely involves the temporomandibular joint (TMJ); when it does, it manifests clinically as a slowly growing and painless preauricular mass that resembles a parotid tumor. TMJ dysfunction, paresthesia, and/or hearing loss can result. We present a case of a large extra-articular PVNS of the TMJ, and we review the literature.

Extra-articular Pigmented Villonodular Synovitis of the Subacromial Space

Pigmented villonodular synovitis (PVNS) is a rare, benign, proliferating disease affecting the synovium of joints, bursae, and tendon sheaths. The knee is the most common site of involvement and accounts for up to 80% of cases. Involvement of the shoulder is extremely rare. Only 1 case of involvement of the subacromial space has been reported worldwide. We report a case of localized extra-articular PVNS of the subacromial space that was satisfactorily treated with open excisional biopsy and subacromial bursectomy after diagnostic glenohumeral arthroscopy. We visualized the glenohumeral joint to rule out articular invasion and intra-articular pathology with an arthroscope, which revealed a highly vascular synovium protruding into the intra-articular area of the rotator interval, with no direct invasion by the extra-articular mass. An open excisional biopsy and subacromial bursectomy was performed. The disease has not recurred during an 18-month follow-up period. The clinical manifestation, treatment, and prognosis of extra-articular PVNS are poorly understood, but if the lesion is left untreated, it can invade the surrounding soft tissue and joint. Therefore, early diagnosis and treatment are important for the satisfactory management of PVNS.

Pigmented villonodular bursitis/diffuse giant cell tumor of the pes anserine bursa: A report of two cases and review of literature

Pigmented villonodular synovitis (PVNS) is a benign but potentially aggressive lesion, characterized by synovial villonodular proliferation with hemosiderin pigmentation and stromal infiltration of histiocytes and giant cells. This consists of a common family of lesions, including localized and diffuse forms of pigmented villonodular synovitis, giant cell tumor of the tendon sheath (nodular tenosynovitis) and the very rare cases of extra-articular pigmented villonodular synovitis arising from the bursa (pigmented villonodular bursitis or diffuse giant cell tumor of the tendon sheath). The purpose of this paper is to present two rare cases of pigmented villonodular bursitis arising from the pes anserinus bursa. The various differentials along with a review of literature of similar lesions are also being discussed. However, as with other lesions, clinicoradiographic features along with close histological correlation is essential for diagnosis.

PET, CT, and MR Imaging of Extra-articular Pigmented Villonodular Synovitis

PET, CT, and MR Imaging of Extra-articular Pigmented Villonodular Synovitis

Two incision synovectomy and radiation treatment for diffuse pigmented villonodular synovitis of the knee with extra-articular component

Diffuse pigmented villonodular synovitis (PVNS) of the knee is a rare, locally aggressive disease. Since 1995 the senior author has been treating patients with diffuse intra- and extra-articular PVNS of the knee with a bimodality treatment protocol, consisting of anterior and posterior open synovectomies in conjunction with external-beam radiation. The purpose of this study was to describe the surgical technique, evaluate our protocol's efficacy in limiting local recurrences, and assess its functional implications and associated morbidities. The medical records of nine consecutive patients were analyzed. Functional results were measured using the Knee Society score. The mean follow-up was 67 months (range 37–103 months). Eight patients were disease free and one patient had local recurrence, which was extra-articular, localized and non-progressive. The mean knee rating and functional rating had significantly improved from 65.2 and 70 preoperatively to 93.7 and 96.6 postoperatively respectively. Maximal knee flexion ranged from 90° to 130°, and only 3 patients developed flexion contractures of 5°. In conclusion our bimodality protocol of anterior and posterior open synovectomies, in conjunction with external-beam radiation, limited the recurrence of diffuse intra- and extra-articular PVNS of the knee. All patients showed good-to-excellent functional outcomes and were able to return to their previous level of activity.

Tenosynovial giant cell tumour of the neck

We report the case of a diffuse tenosynovial giant cell tumour to be found adjacent to the thyroid gland. These tumours, also known as extra-articular pigmented villonodular synovitis, are found more commonly in the fingers, wrist, knee thigh and foot, rarely in the head and neck. These tumours are prone to local recurrence, require a high clinical index of suspicion and if they have atypical features may be extremely difficult to obtain a histological diagnosis.

Metastatic squamous cell carcinoma simulating primary extra-articular pigmented villonodular synovitis: a case for immunohistochemistry

Metastatic squamous cell carcinoma simulating primary extra-articular pigmented villonodular synovitis: a case for immunohistochemistry

Extra-articular pigmented villonodular synovitis of the temporomandibular joint: case report and review of the literature

Abstract. Pigmented villonodular synovitis (PVNS) is a benign proliferative disorder of the synovial tissue, that usually affects the knee, ankle and other major joints. Involvement of the temporomandibular joint is, however, very rare. We describe a new case of recurrent PVNS arising from the temporomandibular joint that was classified as diffuse extra-articular type and was successfully treated surgically. The etiology and clinical features of PVNS are discussed and the previously reported cases in the literature are reviewed.

Extra-articular pigmented villonodular synovitis of the temporomandibular joint: case report and review of the literature

Pigmented villonodular synovitis (PVNS) is a benign proliferative disorder of the synovial tissue, that usually affects the knee, ankle and other major joints. Involvement of the temporomandibular joint is, however, very rare. We describe a new case of recurrent PVNS arising from the temporomandibular joint that was classified as diffuse extra-articular type and was successfully treated surgically. The etiology and clinical features of PVNS are discussed and the previously reported cases in the literature are reviewed.

Extraarticular Pigmented Villonodular Synovitis of the Shoulder A Case Report

A rotator cuff tear was diagnosed in a 57-year-old woman based on physical examination and magnetic resonance imaging studies. At operation, an abnormal bursal lesion also was found. The lesion was completely extraarticular and was identified histologically as pigmented villonodular synovitis. The patient was treated with complete bursectomy and repair of the rotator cuff tear and remains asymptomatic 21 months after operation. Pigmented villonodular synovitis is a condition characterized by cell proliferation and deposition of hemosiderin into the lining tissues of joints, tendons, and bursae. The extraarticular form of pigmented villonodular synovitis is extremely rare and usually represents an extension of a primary intraarticular process. Only a few cases have been reported in which the lesion was found exclusively outside the joint with no intraarticular segment. In reviewing the literature, no case of exclusively extraarticular pigmented villonodular synovitis of the shoulder was found. The sequelae of extraarticular pigmented villonodular synovitis are poorly understood, but this lesion can be locally invasive, and if left untreated, may destroy surrounding tissues. Therefore, early diagnosis and treatment are important for optimal results.