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Z Orthop Unfall 2009; 147(2): 220-224
DOI: 10.1055/s-0029-1185526
Wirbelsäule

© Georg Thieme Verlag KG Stuttgart · New York

Pigmentierte villonoduläre Synovitis der thorakalen Wirbelsäule – operatives Langzeitergebnis: ein Fallbericht

Pigmented Villonodular Synovitis Involving the Thoracic Spine: A Case ReportI. Pechlivanis1 , A. Tannapfel2 , J. Tüttenberg1 , A. Harders3 , K. Schmieder1
  • 1Universitätsmedizin Mannheim, Medizinische Fakultät Mannheim der Universität Heidelberg
  • 2Ruhr-Universität Bochum, Institut für Pathologie
  • 3Ruhr-Universität Bochum, Klinik für Neurochirurgie
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Publication History

Publication Date:
08 April 2009 (online)

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Zusammenfassung

Spinale diffuse Riesenzelltumoren (auch als pigmentierte villonoduläre Synovitis bekannt [PVNS]) sind benigne. Obwohl das Auftreten an der thorakalen Wirbelsäule sehr selten ist, sollte es dennoch differenzialdiagnostisch in Betracht gezogen werden. Wir berichten über den Fall eines 35-jährigen Patienten, bei dem eine expansiv in den Spinalkanal von C7-Th2, intraspinal das Rückenmark komprimierend wachsende Raumforderung mit osteolytischen Veränderungen operativ behandelt wurde. Die histopathologische Diagnose war eine PVNS. In der 2-Jahres-Kontrolle war der Patient beschwerdefrei und es zeigt sich bildmorphologisch kein Anhalt auf einen Rezidivtumor.

Abstract

Spinal diffuse-type giant cell tumours (also known as pigmented villonodular synovitis [PVNS]) are benign. Their occurrence in the thoracic spine is a very rare entity, nevertheless it should be considered in the differential diagnosis. We report about the case of a 35-year-old male presenting with an osteolytic and expansive mass compressing the spinal cord from C7 to Th2. Surgical resection was performed. Histopathological diagnosis was PVNS. 2 years postoperatively the patient was without pain and fully reintegrated in his previous job as a physician.

Schlüsselwörter

Riesenzelltumor - thorakale Wirbelsäule - pigmentierte villonoduläre Synovitis

Key words

giant cell tumour - thoracic spine - pigmented villonodular synovitis

Literatur

  • 1 Rao A S, Vigorita V J. Pigmented villonodular synovitis (giant-cell tumor of the tendon sheath and synovial membrane). A review of eighty-one cases.  J Bone Joint Surg [Am]. 1984;  66 76-94
    PubMedSearch in Google Scholar
  • 2 Jaffe H L, Lichtenstein L, Sutro C J. Pigmented villonodular synovitis, bursitis and tendosynovitis. Discussion of synovial and bursal equivalents of tendosynovial lesion commonly denoted as xanthoma, xanthogranuloma, giant cell tumor or myeloplaxoma of tendon sheat, with some considerations of this tendon sheat lesion itself.  Arch Pathol. 1941;  31 731-765
    PubMedSearch in Google Scholar
  • 3 Flandry F, Hughston J C. Pigmented villonodular synovitis.  J Bone Joint Surg [Am]. 1987;  69 942-949
    PubMedSearch in Google Scholar
  • 4 Al-Nakshabandi N A, Ryan A G, Choudur H. et al . Pigmented villonodular synovitis.  Clin Radiol. 2004;  59 414-420
    CrossrefPubMedSearch in Google Scholar
  • 5 Llauger J, Palmer J, Roson N. et al . Pigmented villonodular synovitis and giant cell tumors of the tendon sheath: radiologic and pathologic features.  AJR Am J Roentgenol. 1999;  172 1087-1091
    PubMedSearch in Google Scholar
  • 6 Ly J Q, Carlson C L, LaGatta L M. et al . Giant cell tumor of the peroneus tendon sheath.  AJR Am J Roentgenol. 2003;  180 1442
    PubMedSearch in Google Scholar
  • 7 Huang G S, Lee C H, Chan W P. et al . Localized nodular synovitis of the knee: MR imaging appearance and clinical correlates in 21 patients.  AJR Am J Roentgenol. 2003;  181 539-543
    PubMedSearch in Google Scholar
  • 8 Jelinek J S, Kransdorf M J, Shmookler B M. et al . Giant cell tumor of the tendon sheath: MR findings in nine cases.  AJR Am J Roentgenol. 1994;  162 919-922
    PubMedSearch in Google Scholar
  • 9 Bui-Mansfield L T, Youngberg R A, Coughlin W. et al . MRI of giant cell tumor of the tendon sheath in the cervical spine.  J Comput Assist Tomogr. 1996;  20 113-115
    CrossrefPubMedSearch in Google Scholar
  • 10 Karasick D, Karasick S. Giant cell tumor of tendon sheath: spectrum of radiologic findings.  Skeletal Radiol. 1992;  21 219-224
    PubMedSearch in Google Scholar
  • 11 Mahmood A, Caccamo D V, Morgan J K. Tenosynovial giant-cell tumor of the cervical spine. Case report.  J Neurosurg. 1992;  77 952-955
    PubMedSearch in Google Scholar
  • 12 Dingle S R, Flynn J C, Flynn Jr J C. et al . Giant-cell tumor of the tendon sheath involving the cervical spine. A case report.  J Bone Joint Surg [Am]. 2002;  84 1664-1667
    PubMedSearch in Google Scholar
  • 13 Gezen F, Akay K M, Aksu A Y. et al . Spinal pigmented villonodular synovitis: a case report.  Spine. 1996;  21 642-645
    CrossrefPubMedSearch in Google Scholar
  • 14 Motamedi B, Richards R S. Giant cell tumor of the proximal phalanx: a case report.  Ann Plast Surg. 1997;  39 314-316
    CrossrefPubMedSearch in Google Scholar
  • 15 Anazawa U, Hanaoka H, Shiraishi T. et al . Similarities between giant cell tumor of bone, giant cell tumor of tendon sheath, and pigmented villonodular synovitis concerning ultrastructural cytochemical features of multinucleated giant cells and mononuclear stromal cells.  Ultrastruct Pathol. 2006;  30 151-158
    PubMedSearch in Google Scholar
  • 16 Sciot R, Rosai J, Dal Cin P. et al . Analysis of 35 cases of localized and diffuse tenosynovial giant cell tumor: a report from the Chromosomes and Morphology (CHAMP) study group.  Mod Pathol. 1999;  12 576-579
    PubMedSearch in Google Scholar
  • 17 Kleinman G M, Dagi T F, Poletti C E. Villonodular synovitis in the spinal canal: case report.  J Neurosurg. 1980;  52 846-848
    PubMedSearch in Google Scholar
  • 18 Campbell A J, Wells I P. Pigmented villonodular synovitis of a lumbar vertebral facet joint.  J Bone Joint Surg [Am]. 1982;  64 145-146
    PubMedSearch in Google Scholar
  • 19 Pulitzer D R, Reed R J. Localized pigmented villonodular synovitis of the vertebral column.  Arch Pathol Lab Med. 1984;  108 228-230
    PubMedSearch in Google Scholar
  • 20 Weidner N, Challa V R, Bonsib S M. et al . Giant cell tumors of synovium (pigmented villonodular synovitis) involving the vertebral column.  Cancer. 1986;  57 2030-2036
    CrossrefPubMedSearch in Google Scholar
  • 21 Retrum E R, Schmidlin T M, Taylor W K. et al . CT myelography of extradural pigmented villonodular synovitis.  AJNR Am J Neuroradiol. 1987;  8 727-729
    PubMedSearch in Google Scholar
  • 22 Karnezis T A, McMillan R D, Ciric I. Pigmented villonodular synovitis in a vertebra. A case report.  J Bone Joint Surg [Am]. 1990;  72 927-930
    PubMedSearch in Google Scholar
  • 23 Kuwabara H, Uda H, Nakashima H. Pigmented villonodular synovitis (giant cell tumor of the synovium) occurring in the vertebral column. Report of a case.  Acta Pathol Jpn. 1992;  42 69-74
    PubMedSearch in Google Scholar
  • 24 Khoury G M, Shimkin P M, Kleinman G M. et al . Computed tomography and magnetic resonance imaging findings of pigmented villonodular synovitis of the spine.  Spine. 1991;  16 1236-1237
    PubMedSearch in Google Scholar
  • 25 Clark L J, McCormick P W, Domenico D R. et al . Pigmented villonodular synovitis of the spine. Case report.  J Neurosurg. 1993;  79 456-459
    PubMedSearch in Google Scholar
  • 26 Titelbaum D S, Rhodes C H, Brooks J S. et al . Pigmented villonodular synovitis of a lumbar facet joint.  AJNR Am J Neuroradiol. 1992;  13 164-166
    PubMedSearch in Google Scholar
  • 27 Giannini C, Scheithauer B W, Wenger D E. et al . Pigmented villonodular synovitis of the spine: a clinical, radiological, and morphological study of 12 cases.  J Neurosurg. 1996;  84 592-597
    PubMedSearch in Google Scholar
  • 28 Bruecks A K, Macaulay R J, Tong K A. et al . November 2000: 13 year old girl with back pain and leg weakness.  Brain Pathol. 2001;  11 263-264
    PubMedSearch in Google Scholar
  • 29 Dimeco F, Rizzo P, Li K W. et al . Pigment villonodular synovitis of the spine. Case report and review of the literature.  J Neurosurg Sci. 2001;  45 216-219
    PubMedSearch in Google Scholar
  • 30 Furlong M A, Motamedi K, Laskin W B. et al . Synovial-type giant cell tumors of the vertebral column: a clinicopathologic study of 15 cases, with a review of the literature and discussion of the differential diagnosis.  Hum Pathol. 2003;  34 670-679
    CrossrefPubMedSearch in Google Scholar
  • 31 Parmar H A, Sitoh Y Y, Tan K K. et al . MR imaging features of pigmented villonodular synovitis of the cervical spine.  AJNR Am J Neuroradiol. 2004;  25 146-149
    PubMedSearch in Google Scholar
  • 32 Hermann J, Stadlmaier E, Aigner C. et al . [Erosive intervertebral joint lesions. A case of pigmented villonodular synovitis].  Z Rheumatol. 2007;  66 152 154-156
    CrossrefPubMedSearch in Google Scholar
  • 33 Hansen M A, Harper C, Yiannikas C. et al . A rare presentation of pigmented villonodular synovitis.  J Clin Neurosci. 2007;  14 386-388
    CrossrefPubMedSearch in Google Scholar
  • 34 Oe K, Sasai K, Yoshida Y. et al . Pigmented villonodular synovitis originating from the lumbar facet joint: a case report.  Eur Spine J. 2007;  16 (Suppl. 3) 301-305
    PubMedSearch in Google Scholar
  • 35 Finn M A, McCall T D, Schmidt M H. Pigmented villonodular synovitis associated with pathological fracture of the odontoid and atlantoaxial instability. Case report and review of the literature.  J Neurosurg Spine. 2007;  7 248-253
    CrossrefPubMedSearch in Google Scholar
  • 36 Rovner J, Yaghoobian A, Gott M. et al . Pigmented villonodular synovitis of the zygoapophyseal joint: a case report.  Spine. 2008;  33 E656-E658
    CrossrefPubMedSearch in Google Scholar

Dr. Ioannis Pechlivanis

Universitätsmedizin Mannheim
Medizinische Fakultät Mannheim der Universität Heidelberg

Theodor-Kutzer-Ufer 1–3

68167 Mannheim

Phone: 06 21/3 83 23 60

Fax: 06 21/3 83 20 04

Email: ioannis.pechlivanis@nch.ma.uni-heidelberg.de