Malignant Pigmented Villonodular Synovitis-A Rare Entity

 

What to Learn from this Article?

Metastatic presentation and management of malignant pigmented Villonodular Synovitis.


Case Report | Volume 4 | Issue 3 | JOCR Oct-Dec 2014 | Page 9-11 | Sistla R, Vidyasagar J.V.S, Afroz T.  DOI: 10.13107/jocr.2250-0685.214


Authors: Sistla R [1], Vidyasagar J.V.S [2], Afroz T [1]

[1] Department of Anatomical Pathology and Cytology, Aware Global Hospitals, L.B Nagar, Hyderabad-500035, Andhra Pradesh. India.

[2] Department of Sports Medicine and Orthopaedics, Aware Global Hospitals, L.B. Nagar, Hyderabad-500035. India.

Address of Correspondence:

Dr. S Radha, H.no-18, Plot No 20, Road No 1, Alakapuri. Hyderabad-500035. Telangana. India. E-mail: sradha_21@hotmail.com


Abstract

Introduction: Malignant pigmented villonodular synovitis (PVNS) or Malignant giant cell tumour tendon sheath (MGCTTS) is a controversial and debatable lesion. Few case reports have indicated the potential for metastasis.1These aggressive cases are designated malignant giant cell tumour tendon sheath or malignant PVNS. Less than 20 cases are described in literature. We report a case of 65 year old lady who was diagnosed eight years back as pigmented villonodular synovitis. She had multiple local recurrences and now presented with lymphnodal metastases, which is extremely rare.

Case Report: Sixty five year old lady presented with swelling in left inguinal region of six months duration. She gave a past history of swelling around medial condyle of left femur eight years back. Swelling was excised three times. At the time of third recurrence, swelling was extensive, infiltrating surrounding tissues and underlying bone, encasing femoral and popliteal vessels for which she underwent an above knee amputation. She now presented with inguinal swelling measuring 5.7×3.0 cms. Positron Emission Tomography Scan (PET-CT) revealed multiple enlarged left common iliac, internal and external iliac nodes, largest measuring 7.0 cms. Both the inguinal and pelvic nodes were excised. Lesion was diagnosed as metastatic deposits of Malignant pigmented villonodular synovitis based on morphological and Immunohistochemical findings.

Conclusion: It is important to have a high index of clinical suspicion because these lesions can have an aggressive behaviour even with bland cytological features. Our experience suggests that in a recurrent lesion for GCTTS. A wide surgical excision with safe surgical margins and close follow up with radiological evaluation might help to diagnose these lesions early and be amenable to limb salvage surgeries.

Keywords: Lymphnode, Metastasis, Pigmented villonodular synovitis, Malignant.


How to Cite This Article:  Sistla R, Vidyasagar J.V.S, Afroz T. Malignant Pigmented Villonodular Synovitis-A Rare Entity. Journal of Orthopaedic Case Reports 2014 Oct-Dec;4(4): 9-11. Available from: http://www.jocr.co.in/wp/2014/11/29/2250-0685-214fulltext/

(Figure 1)|(Figure 2)


Photo


  [Abstract]           [Full Text HTML]         [Full Text PDF]              [XML]


View ratings
Rate this article


Dear Reader, We are very excited about New Features in JOCR. Please do let us know what you think  by Clicking on the Sliding “Feedback Form” button on the  <<< left of the page or sending a mail to us at editor.jocr@gmail.com