giant cell tumours of tendon sheath

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Giant cell tumours of the tendon sheath (GCTTS) (nodular tenosynovitis) and pigmented villonodular synovitis (PNVS) have long been studied

  • conditions are considered to be benign growths of round or polygonal histiocyte-like cells associated with multinucleated giant cells, foam cells, and hemosiderin-laden cells. Although these two conditions are considered related entities, there is a practical difference

  • Giant cell tumours of the tendon sheat (GCTTS)

    • most lesions of GCTTS produce one or more discrete nodules commonly on the tendon sheath or in the small joints of the fingers and toes

    • GCTTS (nodular tenosynovitis, localised pigmented villonodular synovitis) is a solitary benign soft-tissue tumour that most commonly occurs in the hand, with recurrence rates of 25 to 45% (1)
      • postoperative radiotherapy may reduce the recurrence rate to 4%

    • less common sites include large joints, such as the ankle or knee

  • pigmented villonodular synovitis (PNVS)
    • is identified by a diffusely proliferated synovial membrane bearing a villous aspect with or without nodular formation, and most frequently involves the knee joint (2)

      • is a rare, benign, proliferative lesion of synovial tissue

      • typically and most commonly occurs in the knee followed by the hip, ankle, elbow, and shoulder, and in patients who are relatively young (< 40 years)

      • although several surgical methods have been used for treatment of PVNS of the knee, including open and arthroscopic synovectomy, rates of recurrence are high (30-92%)
        • adequate synovectomy is very important to treat diffuse type of disease. Recently, recurrence rates have been reduced, because the extent of the lesion is accurately estimated by MRI preoperatively
        • arthroscopic treatment can be used for localized lesion
          • however it is almost impossible to resect all lesions in the diffuse type lesion because this disease sometimes expands to the extra-articular lesion

Reference:

Last reviewed 01/2018