Sawmiller C J, Turowski G A, Sterling A P, Dudrick S J
Department of Surgery, St. Mary's Hospital, Waterbury, CT 06706, USA.
Clin Orthop Relat Res. 1997 Feb(335):262-7.
A rotator cuff tear was diagnosed in a 57-year-old woman based on physical examination and magnetic resonance imaging studies. At operation, an abnormal bursal lesion also was found. The lesion was completely extraarticular and was identified histologically as pigmented villonodular synovitis. The patient was treated with complete bursectomy and repair of the rotator cuff tear and remains asymptomatic 21 months after operation. Pigmented villonodular synovitis is a condition characterized by cell proliferation and deposition of hemosiderin into the lining tissues of joints, tendons, and bursae. The extraarticular form of pigmented villonodular synovitis is extremely rare and usually represents an extension of a primary intraarticular process. Only a few cases have been reported in which the lesion was found exclusively outside the joint with no intraarticular segment. In reviewing the literature, no case of exclusively extraarticular pigmented villonodular synovitis of the shoulder was found. The sequelae of extraarticular pigmented villonodular synovitis are poorly understood, but this lesion can be locally invasive, and if left untreated, may destroy surrounding tissues. Therefore, early diagnosis and treatment are important for optimal results.
一名57岁女性经体格检查和磁共振成像检查后被诊断为肩袖撕裂。手术时，还发现了一个异常的滑囊病变。该病变完全位于关节外，组织学检查确诊为色素沉着绒毛结节性滑膜炎。患者接受了滑囊完全切除术和肩袖撕裂修复术，术后21个月仍无症状。色素沉着绒毛结节性滑膜炎是一种以细胞增殖和含铁血黄素沉积于关节、肌腱和滑囊内衬组织为特征的疾病。色素沉着绒毛结节性滑膜炎的关节外形式极为罕见，通常是原发性关节内病变的延伸。仅有少数病例报道病变仅位于关节外，无关节内部分。查阅文献发现，尚未有单纯肩关节关节外色素沉着绒毛结节性滑膜炎的病例。关节外色素沉着绒毛结节性滑膜炎的后遗症尚不清楚，但该病变具有局部侵袭性，若不治疗，可能会破坏周围组织。因此，早期诊断和治疗对于取得最佳疗效至关重要。
