Endoscopic Resection of Localized Pigmented Villonodular Synovitis in the Hoffa Fat Pad.
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ABSTRACT:
SUBMITTER: Fan AKH
PROVIDER: S-EPMC6926309 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:Pigmented villonodular synovitis is a disorder resulting in a villous, nodular, or villonodular proliferation of the synovium, with pigmentation related to the presence of hemosiderin. These lesions are almost exclusively benign with rare reports of malignancy. Pigmented villonodular synovitis can occur in a variety of joints and at any age but most often occurs within the knee in the young adult. Pigmented villonodular synovitis is a rare disease entity, and bilateral synchronous or metachronous involvement of a joint is even more uncommon, with few reports previously described in the literature. We present a case of pigmented villonodular synovitis involving both the right and left knee in the same patient, with radiographic imaging, magnetic resonance imaging, photograph and video intraoperative imaging, and pathologic correlation.
| S-EPMC4668628 | biostudies-literature
Project description:Pigmented villonodular synovitis (PVNS) is characterized by hyperplasia of the synovial tissue in joints, of tendon sheaths, and of the mucous membranes, or fibrous tissue adjacent to the tendons. Its etiology is unknown. We report a case of diffuse intra-articular PVNS of the right knee in a 38-year-old man. Ultrasound and magnetic resonance imaging (MRI) features of the disease are described.
| S-EPMC3558236 | biostudies-literature
Project description:Tenosynovial giant-cell tumor (TGCT) and pigmented villonodular synovitis (PVNS) are related conditions with features of both reactive inflammatory disorders and clonal neoplastic proliferations. Chromosomal translocations involving chromosome 1p13 have been reported in both TGCT and PVNS. We confirm that translocations involving 1p13 are present in a majority of cases of TGCT and PVNS and show that CSF1 is the gene at the chromosome 1p13 breakpoint. In some cases of both TGCT and PVNS, CSF1 is fused to COL6A3 (2q35). The CSF1 translocations result in overexpression of CSF1. In cases of TGCT and PVNS carrying this translocation, it is present in a minority of the intratumoral cells, leading to CSF1 expression only in these cells, whereas the majority of cells express CSF1R but not CSF1, suggesting a tumor-landscaping effect with aberrant CSF1 expression in the neoplastic cells, leading to the abnormal accumulation of nonneoplastic cells that form a tumorous mass. Set of arrays organized by shared biological context, such as organism, tumors types, processes, etc. Keywords: Logical Set
2006-02-25 | GSE4166 | GEO
Project description:PurposeTo review clinical characteristics of pigmented villonodular synovitis (PVNS) in China.MethodsElectronic medical records (EMR) of four Chinese institutes were queried for patients with histologically proven PVNS between January 2005 and February 2014. Their data were collected including gender, age at diagnosis, clinical presentation, affected site, symptom duration, comorbidities, treatment strategy, recurrence and routine laboratories.ResultsA total of 237 patients with biopsy-proven PVNS were investigated. The gender ratio was 1.35 for a female predominance (101 males and 136 females). The average age was 36 years (range, 2 to 83 years). The median delay from initial clinical symptom to diagnosis was 18 months. Main affected areas were the knee (73.84%) and the hip (18.14%). Forty patients had a clear history of joint trauma. Six patients were concurrently diagnosed with PVNS and avascular necrosis (AVN). Five patients suffered from PVNS following implantation of orthopaedic devices including artificial prosthesis, plate and wire. One hundred and twenty-nine patients underwent arthroscopic synovectomy and 108 open synovectomy. Altogether 48 patients (26 males and 22 females) had recurrence of disease. The relapse rate was 24% (knee) and 6.98% (hip), 20.93% (open surgery) and 19.44% (arthroscopy), respectively. Erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) rate were elevated in 45.83% and 38.41% of the patients respectively.ConclusionsTo our knowledge, this study is the largest sample size of PVNS patients reported as well as the largest sample of PVNS with concurrent AVN reported to date. Our outcomes suggest that PVNS shows a female predominance, occurs mostly between 20-40 years and favors the knee and hip. Recurrence is frequent, particularly in the knee. Serum ESR and CRP may be elevated in some patients. Additionally, the present study supports the theory of an association between PVNS and orthopedic surgery, which is not limited to joint replacement.
| S-EPMC4370558 | biostudies-literature
Project description:Pigmented villonodular synovitis (PVNS) is a monoarticular, benign tumor arising from the synovium. Although classically treated with open synovectomy, arthroscopic treatment has demonstrated good clinical outcomes. The arthroscopic management of hip PVNS has been described as technically challenging due to difficulty obtaining the appropriate exposure. The purpose of this technical report is to describe a novel technique that allows for sound excision of PVNS during hip arthroscopy using a puncture capsulotomy. Full visualization throughout the central and peripheral compartments is key to achieving meticulous surgical excision and ablation, with careful attention to the medial and lateral synovial folds and gutters. It is important to avoid chondral injury by using a high outflow rate of irrigation to maintain a constant temperature, to ablate the blood supply of nodular lesions, and to not use a shaver as this may disseminate tumor cells. Multifactorial advancements in hip arthroscopy have permitted adequate visualization and exposure of PVNS lesions, making them amenable to arthroscopic synovectomy. Puncture capsulotomy does not require capsular closure, preserves the iliofemoral ligament, and minimizes exposure of extra-articular structures to the hip joint environment. Recurrence rates are lower in arthroscopic management compared with open management, at 7.7% and 17.8%, respectively.
| S-EPMC6624174 | biostudies-literature
Project description:Open synovectomy remains the treatment of choice for pigmented villonodular synovitis (PVNS) of the hip but has shown modest results compared with the treatment of other joints. Recent advances in hip arthroscopy permit a thorough evaluation of the joint surfaces, improved access, and decreased postoperative morbidity. We describe an arthroscopic synovectomy technique for PVNS of the hip. The use of additional arthroscopic portals and creation of a large capsulotomy enable successful visualization and extensive synovectomy of the entire synovial lining of the hip. The T-capsulotomy enables extensive soft-tissue retraction for complete exposure. The midanterior portal enables use of an arthroscopic grasper and shaver to directly access and excise the synovial lining of the peripheral compartment while avoiding damage to the medial and lateral retinacular vessels. Technical innovations in hip arthroscopy have enhanced visualization in the central and peripheral compartments, as well as instrument management and diagnostic evaluation of the capsule, therefore allowing enhanced management of PVNS of the hip.
| S-EPMC4427644 | biostudies-literature
Project description:Tenosynovial giant-cell tumor (TGCT) and pigmented villonodular synovitis (PVNS) are related conditions with features of both reactive inflammatory disorders and clonal neoplastic proliferations. Chromosomal translocations involving chromosome 1p13 have been reported in both TGCT and PVNS. We confirm that translocations involving 1p13 are present in a majority of cases of TGCT and PVNS and show that CSF1 is the gene at the chromosome 1p13 breakpoint. In some cases of both TGCT and PVNS, CSF1 is fused to COL6A3 (2q35). The CSF1 translocations result in overexpression of CSF1. In cases of TGCT and PVNS carrying this translocation, it is present in a minority of the intratumoral cells, leading to CSF1 expression only in these cells, whereas the majority of cells express CSF1R but not CSF1, suggesting a tumor-landscaping effect with aberrant CSF1 expression in the neoplastic cells, leading to the abnormal accumulation of nonneoplastic cells that form a tumorous mass. Set of arrays organized by shared biological context, such as organism, tumors types, processes, etc. Computed
2006-02-24 | E-GEOD-4166 | biostudies-arrayexpress
Project description:Pigmented villonodular synovitis (PVNS) is a benign aggressive disease that presents in either a localized (LPVNS) or diffuse (DPVNS) form. Arthroscopic synovectomy is the standard operative treatment for LPVNS, and when used to treat DPVNS, it is usually combined with an open posterior procedure. The purpose of this Technical Note is to report the technique that we have refined to allow for arthroscopic synovectomy as the sole treatment for DPVNS. We describe our technique with the factors we have found to be important to ensure adequate arthroscopic synovectomy, while minimizing risks and complications. The combination of additional portals, the use of multiple different shavers and arthroscopes, and the use of a leg holder all maximize our ability to clear disease.
| S-EPMC5709822 | biostudies-other
Project description:Pigmented villonodular synovitis (PVNS) is a benign proliferative joint disease, which is a rare finding after total knee arthroplasty (TKA). There is currently no link between PVNS and TKA, and it has been described infrequently in the literature. Its presentation has varied along with the time that it presents postoperatively. We describe a case of a patient who presents with recurrent hemarthrosis 4 years after TKA. The patient had no previous history of PVNS and had an arthroscopy 1 year after the index operation with no evidence of synovitis. We present details of the first case with a review of imaging and pathology and a brief review of the literature on PVNS occurring after TKA.
| S-EPMC6287230 | biostudies-literature
Project description:We orthopaedic surgeons are not familiar with the popliteus bursa. It is defined as the expansion in the synovial membrane of the posterolateral part of the knee that lies between the lateral meniscus and the tendon of the popliteus muscle. The popliteus bursa extends approximately 1 cm distal to the joint line and has 4 borders; the medial border is the peripheral margin of the lateral meniscus, the lateral border is the popliteus tendon, and the superior and inferior borders are formed by 2 fascicles. We very rarely observe cystic lesions that expand more distally, such as pigmented villonodular synovitis (PVNS) and synovial osteochondromatosis. We consider the distally expanded bursa as the pathologic expansion of the popliteus bursa. When this expansion is involved with PVNS, it may be the cause of recurrence of PVNS in the knee joint. Synovial osteochondromatosis in this expansion may cause pain in the posterolateral corner of the knee and may become a source of free bodies in the knee joint. In such conditions, these lesions should be surgically excised. The purpose of this Technical Note is to describe a surgical approach to the pathologic expansion of the popliteus bursa.
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