Schnirring-Judge Molly, Lin Bonnie
Kaiser Permanente Foundation/Cleveland Clinic Foundation, Cleveland, OH, USA.
J Foot Ankle Surg. 2011 Jan-Feb;50(1):108-16. doi: 10.1053/j.jfas.2010.10.001.
Pigmented villonodular synovitis (PVNS) is a rare, benign, idiopathic proliferative disorder of the synovium that results in villous and or nodular formations that have been reported to manifest within joints, tendon sheaths, and bursae. The overall incidence includes 2% to 10% that occur within the foot and ankle joints. PVNS has a high rate of recurrence and up to a 45% recurrence rate has been reported despite surgical intervention. Although traditional treatment for PVNS includes synovectomy with arthroplasty of the affected joint, radiation therapy is now suggested as an adjunctive therapy that is believed to reduce recurrence of the disease. We present a case of PVNS where the patient was treated in 2 stages: surgical resection of the tumor with arthroplasty of the ankle joint followed by radiation therapy. A retrospective review of the chart, radiographs, and MRIs was conducted for a 36-year-old, African American female who had been treated and followed for 8 years. Pathologic examination of the tumor confirmed the diagnosis of PVNS. No evidence of recurrent PVNS was identified in the long-term postoperative MRI examination. The fact that ancillary imaging examinations failed to reveal evidence of recurrence and that the patient expresses a very high patient satisfaction supports the potential benefit of adjunctive radiation therapy for this condition.
色素沉着绒毛结节性滑膜炎（PVNS）是一种罕见的、良性的、特发性滑膜增生性疾病，可导致绒毛状和/或结节状形成，据报道可出现在关节、腱鞘和滑囊内。总体发病率包括2%至10%发生在足踝关节内。PVNS复发率高，尽管进行了手术干预，但据报道复发率高达45%。虽然PVNS的传统治疗包括对受影响关节进行滑膜切除术和关节成形术，但现在建议将放射治疗作为辅助治疗，据信可降低疾病复发率。我们报告一例PVNS病例，该患者分两个阶段进行治疗：先对肿瘤进行手术切除并对踝关节进行关节成形术，然后进行放射治疗。对一名接受治疗并随访8年的36岁非裔美国女性的病历、X光片和磁共振成像进行了回顾性分析。肿瘤的病理检查证实了PVNS的诊断。长期术后磁共振成像检查未发现PVNS复发的证据。辅助成像检查未能发现复发证据且患者表示非常满意这一事实支持了辅助放射治疗对这种疾病的潜在益处。
