The Knee Tenosynovial Giant Cell Tumor: A Deceptive Case Report with Non-Specific Presentations
Abstract
Background: Tenosynovial giant cell tumor (TGCT) is a rare hyperplastic disease of the synovial membrane of the joint with a high recurrence rate and tumor-like features, affecting large joints such as the hip, knee, and ankle. Dull and chronic pain is common, as is swelling of the joint, which can make definitive diagnosis difficult. The gold standard of treatment is complete resection of the lesion. In this case report, we present a TGCT at the knee joint of an adult patient with nonspecific clinical presentation.
Case Report: We present a 33-year-old male patient who presented with chronic swelling, warm sensation, and limited range of motion (ROM) in the knee. He had no history of trauma and infectious disease had been ruled out. After several nonspecific orthopedic procedures and inadequate treatment of signs and symptoms, he was finally diagnosed with local TGCT.
Conclusion: To make the correct diagnosis, the unusual and somehow deceptive clinical presentation of TGCT must be considered.
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11. Keyhani S, Kazemi SM, Ahn JH, Verdonk R, Soleymanha M. Arthroscopic treatment of diffuse pigmented villonodular synovitis of the knee: Complete synovectomy and septum removal-midterm results. J Knee Surg. 2019;32(5):427-33. doi: 10.1055/s-0038-1646929. [PubMed: 29727868].
12. Bojanic I, Ivkovic A, Dotlic S, Ivkovic M, Manojlovic S. Localized pigmented villonodular synovitis of the knee: diagnostic challenge and arthroscopic treatment: A report of three cases. Knee Surg Sports Traumatol Arthrosc. 2001;9(6):350-4. doi: 10.1007/s001670100231. [PubMed: 11734872].
13. Kapoor C, Jhaveri M, Soni R, Shah M, Rathi P, Golwala P. Pigmented villonodular synovitis of the knee joint: A case report. Cureus. 2016;8(10):e816. doi: 10.7759/cureus.816. [PubMed: 27843734]. [PubMed Central: PMC5101109].
14. Kazemi SM, Hosseininejad SM. Hip tenosynovial giant cell tumor without recurrence in a 9-year follow-up. Case Rep Orthop. 2022;2022:1797218. doi: 10.1155/2022/1797218. [PubMed: 35154840]. [PubMed Central: PMC8837448].
2. Tap WD, Healey JH. Role of colony-stimulating factor 1 in the neoplastic process of tenosynovial giant cell tumor. Tumour Biol. 2022;44(1):239-48. doi: 10.3233/TUB-220005. [PubMed: 36502356].
3. Bernthal NM, Spierenburg G, Healey JH, Palmerini E, Bauer S, Gelderblom H, et al. The diffuse-type tenosynovial giant cell tumor (dt-TGCT) patient journey: A prospective multicenter study. Orphanet J Rare Dis. 2021;16(1):191. doi: 10.1186/s13023-
021-01820-6. [PubMed: 33926503]. [PubMed Central: PMC8086070].
4. Kim SJ, Shin SJ, Choi NH, Choo ET. Arthroscopic treatment for localized pigmented villonodular synovitis of the knee. Clin Orthop Relat Res. 2000;(379):224-30. doi: 10.1097/00003086-200010000-00026. [PubMed: 11039810].
5. Lee M, Mahroof S, Pringle J, Short SC, Briggs TW, Cannon SR. Diffuse pigmented villonodular synovitis of the foot and ankle treated with surgery and radiotherapy. Int Orthop. 2005;29(6):403-5. doi: 10.1007/s00264-005-0004-8. [PubMed: 16622915]. [PubMed Central: PMC2231588].
6. Wu CC, Pritsch T, Bickels J, Wienberg T, Malawer MM. Two
incision synovectomy and radiation treatment for diffuse pigmented villonodular synovitis of the knee with extra-articular component. Knee. 2007;14(2):99-106. doi: 10.1016/j.knee.2006.10.014. [PubMed: 17161949].
7. Daoud J, Aouad D, Hassan Y, El Rassi G. Localized pigmented villonodular synovitis of the posterior knee compartment with popliteal vessel compression: A case report of arthroscopic resection using only anterior knee portals. Case Rep Orthop. 2018;2018:7532358. doi: 10.1155/2018/7532358. [PubMed: 30034899]. [PubMed Central: PMC6033245].
8. Neubauer P, Weber AK, Miller NH, McCarthy EF. Pigmented villonodular synovitis in children: A report of six cases and review of the literature. Iowa Orthop J. 2007;27:90-4. Retrieved from. [PubMed: 17907437]. [PubMed Central: PMC2150657].
9. Coutinho M, Laranjo A, Casanova J. Pigmented Villonodular Synovitis: A diagnostic challenge. Review of 28 cases. Acta Reumatol Port. 2012;37(4):335-41. [In Portuguese]. [PubMed: 24126425].
10. Xie GP, Jiang N, Liang CX, Zeng JC, Chen ZY, Xu Q, et al. Pigmented villonodular synovitis: A retrospective multicenter study of 237 cases. PLoS One. 2015;10(3):e0121451. doi: 10.1371/journal.pone.0121451. [PubMed: 25799575]. [PubMed Central: PMC4370558].
11. Keyhani S, Kazemi SM, Ahn JH, Verdonk R, Soleymanha M. Arthroscopic treatment of diffuse pigmented villonodular synovitis of the knee: Complete synovectomy and septum removal-midterm results. J Knee Surg. 2019;32(5):427-33. doi: 10.1055/s-0038-1646929. [PubMed: 29727868].
12. Bojanic I, Ivkovic A, Dotlic S, Ivkovic M, Manojlovic S. Localized pigmented villonodular synovitis of the knee: diagnostic challenge and arthroscopic treatment: A report of three cases. Knee Surg Sports Traumatol Arthrosc. 2001;9(6):350-4. doi: 10.1007/s001670100231. [PubMed: 11734872].
13. Kapoor C, Jhaveri M, Soni R, Shah M, Rathi P, Golwala P. Pigmented villonodular synovitis of the knee joint: A case report. Cureus. 2016;8(10):e816. doi: 10.7759/cureus.816. [PubMed: 27843734]. [PubMed Central: PMC5101109].
14. Kazemi SM, Hosseininejad SM. Hip tenosynovial giant cell tumor without recurrence in a 9-year follow-up. Case Rep Orthop. 2022;2022:1797218. doi: 10.1155/2022/1797218. [PubMed: 35154840]. [PubMed Central: PMC8837448].
| Files | ||
| Issue | Vol 9 No 4 (2023) | |
| Section | Case Report | |
| DOI | https://doi.org/10.18502/jost.v9i4.13938 | |
| Keywords | ||
| Giant Cell Tumor of Tendon Sheath Pigmented Villonodular Synovitis Arthroscopy | ||
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How to Cite
1.
Kazemi S-M, Minaie-Noshani R, Hosseininejad S-M. The Knee Tenosynovial Giant Cell Tumor: A Deceptive Case Report with Non-Specific Presentations. J Orthop Spine Trauma. 2023;9(4):192-4.
