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Open synovectomy treatment for intra- and extraarticular localized pigmented villonodular synovitis of the knee: a case report
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 rel...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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BioMed Central
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7792229/ https://www.ncbi.nlm.nih.gov/pubmed/33413272 http://dx.doi.org/10.1186/s12891-020-03895-x |
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author | Xu, Daoliang Wen, Jianxia Zhang, Shisi Pan, Xiaoyun |
author_facet | Xu, Daoliang Wen, Jianxia Zhang, Shisi Pan, Xiaoyun |
author_sort | Xu, Daoliang |
collection | PubMed |
description | 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. |
format | Online Article Text |
id | pubmed-7792229 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-77922292021-01-11 Open synovectomy treatment for intra- and extraarticular localized pigmented villonodular synovitis of the knee: a case report Xu, Daoliang Wen, Jianxia Zhang, Shisi Pan, Xiaoyun BMC Musculoskelet Disord Case Report 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. BioMed Central 2021-01-07 /pmc/articles/PMC7792229/ /pubmed/33413272 http://dx.doi.org/10.1186/s12891-020-03895-x Text en © The Author(s) 2021 Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Case Report Xu, Daoliang Wen, Jianxia Zhang, Shisi Pan, Xiaoyun Open synovectomy treatment for intra- and extraarticular localized pigmented villonodular synovitis of the knee: a case report |
title | Open synovectomy treatment for intra- and extraarticular localized pigmented villonodular synovitis of the knee: a case report |
title_full | Open synovectomy treatment for intra- and extraarticular localized pigmented villonodular synovitis of the knee: a case report |
title_fullStr | Open synovectomy treatment for intra- and extraarticular localized pigmented villonodular synovitis of the knee: a case report |
title_full_unstemmed | Open synovectomy treatment for intra- and extraarticular localized pigmented villonodular synovitis of the knee: a case report |
title_short | Open synovectomy treatment for intra- and extraarticular localized pigmented villonodular synovitis of the knee: a case report |
title_sort | open synovectomy treatment for intra- and extraarticular localized pigmented villonodular synovitis of the knee: a case report |
topic | Case Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7792229/ https://www.ncbi.nlm.nih.gov/pubmed/33413272 http://dx.doi.org/10.1186/s12891-020-03895-x |
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