Pigmented villonodular synovitis: extrasynovial recurrence

Arthroscopy. 2011 Oct;27(10):1449-51. doi: 10.1016/j.arthro.2011.06.023. Epub 2011 Sep 1.


A 32-year-old female athlete underwent arthroscopy for a second recurrence of pigmented villonodular synovitis (PVNS), which was extrasynovial, seen on magnetic resonance imaging. It was noted on arthroscopy that (1) the nodules moved medially with joint insufflation, (2) the nodules were less prominent than on magnetic resonance imaging, and (3) more than 95% of the recurrent tumor was hidden by neosynovium. We believe that the extrasynovial location is because of the more rapid proliferation of the neosynovium relative to the growth of the remaining tumor cells after the previous resection. In resecting pigmented villonodular synovitis with a high risk of recurrence, a layer of periarticular fat should be removed and the surgeon should be wary of change in position with insufflation.

Publication types

  • Case Reports
  • Video-Audio Media

MeSH terms

  • Adipose Tissue / surgery
  • Adult
  • Arthroscopy*
  • Female
  • Humans
  • Hydrarthrosis / etiology
  • Hydrarthrosis / surgery
  • Insufflation
  • Jogging / injuries
  • Knee Joint / surgery*
  • Magnetic Resonance Imaging
  • Recurrence
  • Synovitis, Pigmented Villonodular / pathology
  • Synovitis, Pigmented Villonodular / surgery*