Jungbluth P, Hopf K F, Wick M, Homann H, Kagel T, Kuhnen C, Muhr G, Kälicke T
Chirurgische Klinik und Poliklinik, BG-Kliniken Bergmannsheil, Universität Bochum.
Unfallchirurg. 2005 Jun;108(6):511-6. doi: 10.1007/s00113-004-0879-7.
Pigmented villonodular synovitis is a rare proliferative disorder of the synovial membrane most frequently found in the knee. The etiopathology of the disease is still not understood. Present terminology differentiates between a localized (LPVNS) and a diffuse (DPVNS) form. Currently, MRI is the diagnostic imaging technique of choice. The localized form (LPVNS) can be cured definitely in almost all cases by partial arthroscopic synovectomy, whereas the treatment of the diffuse form (DPVNS) is discussed controversially concerning an arthroscopic or total synovectomy by open arthrotomy. We report a case rarely found in the literature of a patient suffering from a diffuse form of PVNS localized in the right knee joint. In this case PVNS acted as a locally aggressive and destructive lesion of immense extent invading femoral, tibial and fibular bone and the whole extending muscular system. We performed a radical synovectomy by open arthrotomy. By implanting a tumor prosthesis we prevented progression of the disease. Apart from adequate diagnosis, we recommend complete and aggressive resection of the affected tissue by performing an open arthrotomy.
色素沉着绒毛结节性滑膜炎是一种罕见的滑膜增生性疾病,最常发生于膝关节。该病的病因病理仍不清楚。目前的术语将其分为局限性(LPVNS)和弥漫性(DPVNS)两种形式。目前,MRI是首选的诊断成像技术。局限性形式(LPVNS)几乎在所有病例中都可通过关节镜下部分滑膜切除术得到根治,而弥漫性形式(DPVNS)的治疗在关节镜手术或开放关节切开术进行全滑膜切除术方面存在争议。我们报告了一例文献中罕见的病例,患者患有弥漫性PVNS,病变位于右膝关节。在该病例中,PVNS表现为局部侵袭性和破坏性病变,范围巨大,侵犯了股骨、胫骨和腓骨以及整个肌肉系统。我们通过开放关节切开术进行了根治性滑膜切除术。通过植入肿瘤假体,我们防止了疾病的进展。除了充分诊断外,我们建议通过开放关节切开术对受影响组织进行彻底和积极的切除。