J Korean Foot Ankle Soc.  2019 Sep;23(3):139-142. 10.14193/jkfas.2019.23.3.139.

Surgical Treatment for Diffuse Pigmented Villonodular Synovitis of the Ankle by A Combined Open and Arthroscopic Synovectomy: A Case Report

• Choi JC
• Song WS
• Byun CW
• Kim J
• Han EM

• KMID: 2458017
• DOI: http://doi.org/10.14193/jkfas.2019.23.3.139

Abstract

Pigmented villonodular synovitis (PVNS) is a rare proliferative disease involving the synovial membranes. Complete excision with a total synovectomy is important for diffuse type PVNS because of its high recurrence rate. In the ankle, complete excision of diffuse type PVNS is difficult due to the anatomical structure of the ankle joint. This paper reports the author's experience of surgical treatment with combined open and arthroscopic synovectomy. In this manner, it is expected that the complications of the open procedure and the recurrence rate of arthroscopic procedure can be reduced.

Keyword

Pigmented villonodular synovitis; Ankle; Synovectomy

MeSH Terms

Ankle Joint
Ankle*
Recurrence
Synovial Membrane
Synovitis, Pigmented Villonodular*

Figure

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  Figure 1 Magnetic resonance imaging of left ankle. T1-, T2-weighted fat suppressed sagittal (A) and axial (B) images show large sized mass of low signal intensity in anterior and posterior aspect of ankle (arrows).

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  Figure 2 Anterior arthroscopic approach findings. (A) Diffuse synovial hypertrophy was found. (B) Diffuse hemosiderin deposition and hemorrhagic lesion were found. (C) Bony erosion of talar neck was found.

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  Figure 3 Posterior approach showing a pigmented villonodular synovitis mass (A) after through debridement (B).

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  Figure 4 The yellowish-brown pigmented villonodular synovitis mass tumor specimen after synovectomy. Anterior compartment (A) and posterior compartment (B).

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  Figure 5 The tumor consists of mononuclear cells, a few multinucleated giant cells and some foamy macrophages (H&E stain, ×40).

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