J Korean Soc Radiol.  2016 Oct;75(4):322-326. 10.3348/jksr.2016.75.4.322.

Tenosynovial Giant Cell Tumor of the Pes Anserine Bursa with Bone Marrow Extension into the Tibia: A Case Report

• Kim SJ
• Kang YK
• Yoo CY
• Kim JY

• KMID: 2353685
• DOI: http://doi.org/10.3348/jksr.2016.75.4.322

Abstract

Extra-articular diffuse-type tenosynovial giant cell tumor (TSGCT), especially arising from the pes anserine bursa, is a rare lesion. Only one case of extra-articular diffuse-type TSGCT of the pes anserine bursa that showed bone erosion as an imaging finding has been reported. Here, we report our experience of an exceptional case of extra-articular diffuse-type TSGCT of the pes anserine bursa with intramedullary extension into the tibia on magnetic resonance imaging, which resembled a benign soft tissue mass on radiography, along with a review of the literature.

MeSH Terms

Anserine*
Bone Marrow*
Bursa, Synovial
Giant Cell Tumors*
Giant Cells*
Magnetic Resonance Imaging
Radiography
Tibia*
Anserine

Figure

• 

  Fig. 1 A 41-year-old female presents with a slow-growing, painless mass on the right proximal leg. A, B. Initial radiographs show a juxtacortical lobulated soft tissue mass with an eccentric geographic osteolytic lesion with a thick sclerotic rim in the proximal tibia. C. A 4.9 × 3-cm-sized, lobulated, solid mass that is isointense or hypointense compared to the muscle on axial T1-weighted MRI at the insertion of the pes anserinus conjoined tendon. D. Axial T2-weighted MRI with fat suppression reveals the same mass with hypo- to hyperintensity compared to the muscle. E. The mass is heterogeneously enhanced on contrast-enhanced T1-weighted MRI with fat suppression. F. Coronal T1-weighted MRI with fat suppression after contrast infusion shows the longitudinal aspect of the mass. G. Gradient echo coronal T2-weighted MRI demonstrates peripherally located, low signal intensity dots in the mass. H. The tendons of the semitendinosus, gracilis, and sartorius muscles are encased by the mass. I. A high-power micrograph demonstrates a variable number of hemosiderin granules (arrows) located in multinucleated giant cells and sheets of mononuclear cells (hematoxylin and eosin, original magnification × 400).

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