• Radiation Oncology Journal
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• v.25 no.4
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• pp.278-282
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• 2007

Purpose: Diffuse pigmented villonodular synovitis (PVNS) is an uncommon aggressive synovial proliferative disorder of unknown etiology affecting the joint linings. Though a histologically benign inflammatory process, because of its aggressive growth with bone destruction or recurrence, it is frequently suggested to occur as a low malignant neoplasm. Optimal treatment is surgery, but the local recurrence rate after radical synovectomy for diffuse PVNS is relatively high due to the infiltrative growth pattern. External beam radiotherapy with moderate doses or intra-articular instillation of radioactive isotopes may improve the likelihood of local control and long-term function in patients with incompletely resected or recurrent diffuse PVNS. I report one case of diffuse PVNS of the right knee joint treated with arthroscopic synovectomy and external beam radiotherapy is presented.

• Journal of the Korean Arthroscopy Society
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• v.13 no.3
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• pp.264-267
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• 2009

Pigmented villonodular synovitis (PVNS) is a benign proliferative disorder of the synovium of joints. It occurs most commonly in the knee joint. The disease is composed of 2 different forms: diffuse and localized. The localized form is less frequent than the diffuse one. Most cases of localized PVNS involve the anterior compartment of the knee and can be usually easily diagnosed and treated with arthroscopy. We experienced a patient of localized PVNS developed on the posterior cruciate ligament, whose main symptom was persistent pain after trauma. This case occurs rarely and complete removal of the lesion was performed arthroscopically, using posterior trans-septal portal. We report this case with review of literatures.

• The Journal of the Korean bone and joint tumor society
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• v.16 no.1
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• pp.27-36
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• 2010

Purpose: Pigmented villonodular synovitis (PVNS) is a rare soft tissue tumor, which usually arises in larger joints, such as the knee. It has a high recurrence rate after surgical treatment. The purpose of this study is to evaluate and analyze the clinical results of diffuse-type pigmented villonodular synovitis cases that were treated with open total synovectomy. Materials and Methods: Between 1994 and 2006, 21 patients who had diffuse-type pigmented villonodular synovitis were selectively reviewed. Among the 21 cases studied, 14 patients presented at the knee, 5 at the ankle, and 2 at the shoulder and elbow. The mean follow up period was 5.5 years (range, 36-157 months). The average age of the patients was 34 years consist of 7 men and 14 women. Clinical outcomes were analyzed retrospectively, including range of motion and complications. Results: Open total synovectomy and adjuvant electrocautrization were done in all cases except one. During the regular follow-up period after the surgery, two patients showed symptoms of recurrence. After re-operation, only one case was pathologically confirmed as a recurrence. The patient who had partial synovectomy and the other patient who had second operation due to recur rence received additional radiation therapy. Clinical outcome scores were improved in every aspect (p<0.0001). 2 out of 14 Patients who had pigmented villonodular synovitis at the knee developed stiff knee after the surgery. Conclusion: After the open total synovectomy with electrocautrization, a low recurrence rate and satisfactory clinical outcome was achieved, observed in a minimum of 3 years of follow-up.

• Radiation Oncology Journal
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• v.24 no.3
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• pp.201-206
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• 2006

Pigmented villonodular synovitis (PVNS) is a rare proliferative disease involving synovial membranes. Natural history and etiology of PVNS are not well known. PVNS presents as localized or diffuse tumor like nodular lesion of the synovial lining of the joint and the synovial spaces adjacent to the joints. Though histologically benign, it is a very aggressive lesion, capable of bone destruction and widespread infiltration of surrounding tissues. Standard therapy is surgical resection, but due to the infiltrative growth, the recurrence rate is significantly high. After several relapses surgical treatment of diffuse PVNS becomes difficult and may require amputation of the involved limb. Radiotherapy can provide an effective treatment option for patients with large lesions or lesions which are not suitable for surgery, after incomplete resection to prevent relapses or to avoid amputation. We report 2 cases of diffuse PVNS in the knee joint treated with arthroscopic gross total synovectomy and radiotherapy.

• Investigative Magnetic Resonance Imaging
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• v.11 no.1
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• pp.54-57
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• 2007

Localized nodular synovitis of the knee joint is a rare benign tumorous condition, and should be differentially diagnosed with pigmented villonodular synovitis. We report a case of localized nodular synovitis in the knee that was noted to have a pedicle and characteristic findings on MR image.

• The Academic Congress of Korean Shoulder and Elbow Society
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• 2008.03a
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• pp.172-172
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• 2008

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 marginal excision; 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, we believe that early diagnosis and treatment are important for the satisfactory management of PVNS.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.28 no.5
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• pp.353-357
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• 2002

Pigmented villonodular synovitis(PVNS) usually presents as a benign proliferative monoarticular arthritis that affects the knee in 80% of cases, followed in frequency by the hip, ankle, and calcaneocuboid joint. PVNS rarely affects temporomandibular joint area. Patients typically complain of pain, locking, and recurrent swelling. Tumor progression limits the range of movement of the joint and causes it to become stiff and firm. Sometimes a palpable mass can be appreciated. Aggressive form of PVNS invades into adjacent bones and soft tissues, is confused with other types of neoplasia. Here we report 2 cases of the PVNS on a temporomadibular

• Journal of the Korean Arthroscopy Society
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• v.5 no.1
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• pp.22-26
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• 2001

Purpose : To confirm the efficacy of arthroscopic synovectomy fur the pigmented villonodular synovitis in the knee. Materials and Methods : Between October 1996 and February 2000, the arthroscopic synovectomy had been performed in six patients(six knee joints), whose diagnoses were confirmed by pathologist. All patients complained of painful swelling in involved knee and four of the six patients had trauma history. There were three male and three female patients. Average age was 35.8 years ranging from 16 to 67 years. Follow up period was average 22.7 months(range, $13\~53$ months). Results : According to arthroscopic findings, there were three localized forms and three diffuse forms. At their last follow-up examinations, all patients had improvement in pain, swelling and range of motion and there was no evidence of recurrence. Conclusion : Complete arthroscopic excision is the definitive treatment for localized pigmented villonodular synovitis and meticulous arthroscopic excision through all portals including posterior portal can be considered as a valid alternative to traditional open synovectomy for the patients with diffuse pigmented villonodular synovitis.

• Clinics in Shoulder and Elbow
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• v.15 no.2
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• pp.138-142
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• 2012

Pigmented villonodular synovitis (PVNS) is a rare benign proliferative disorder that results in villous hyperplasia and nodule formation in the synovium, tendon sheath and bursa. That most commonly affects the knee and the hip joint in adult. PVNS of the hand, the wrist, the shoulder and the elbow is rare and that of the elbow in children is particularly rarer. An eight-year-old boy had his left elbow pain and a lesion like benign bone tumor in the left fossa olecrani on plain x-ray. During the operation, abnormal synovial hyperplasia in his left elbow joint led us to diagnose PVNS. Therefore, open curettage of the lesion and radical synovectomy was performed. The specimen of the synovectomized tissue revealed PVNS. The left elbow pain subsided after the operation and the child restored a full range of motion of his left elbow. We reported this rare case of PVNS in a child's elbow joint mimicking the bone tumor together with a review of the literature.

• Journal of the Korean Arthroscopy Society
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• v.3 no.2
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• pp.121-126
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• 1999

Diagnosis of localized pigmented villonodular synovitis (PVNS) is difficult because of its rarity and indistinctive symptoms. This study presented 11 cases of localized PVNS of the knees, which were diagnosed and treated by arthroscopic technique. There were 6 males and 5 females between the age of 15 and 59 years (mean 34.6 years). The interval from the onset of symptoms to treatment ranged from 2 months to 3 years (average 29.9 months). All patients complained knee pain and 7 patients complained palpable mass. Four of the 11 patients had trauma history. The most common involved site was anteromedial synovium near the anterior horn of medial meniscus (5 patients). The remaining cases were identified on anterior fat pad (2 cases), suprapatellar pouch, posteromedial compartment, medial gutter and the anterior horn of the lateral meniscus, respectively. Nine cases had 1 mass and the remaining cases each had 2 or 3 masses. There was no evidence of recurrence during the follow-up period (average 29.9 months). Arthroseopy is effective in the diagnosis of localized PVNS with minimal morbidity and in the definitive treatment for PVNS.