Tenosynovial Giant Cell Tumor, Diffuse Type/Pigmented Villonodular Synovitis in a Pars Defect: A Case Report

Spine (Phila Pa 1976). 2015 Jun 15;40(12):E735-9. doi: 10.1097/BRS.0000000000000923.


Study design: Case report.

Objective: To describe a rare case of tenosynovial giant cell tumor, diffuse type/pigmented villonodular synovitis (PVNS) in a pars defect in a patient with lumbar spondylolysis.

Summary of background date: PVNS rarely occurred in lumbar spine, and no studies in the English literature have reported PVNS in a pars defect in lumbar spondylolysis.

Methods: The patient was a 14-year-old female presented with a 5-month history of low back pain. Plain radiography showed spondylolysis at L5 and computed tomography revealed a 1 × 2-cm slightly eroding tumorous mass at the left L5 pars. On magnetic resonance imaging, the mass showed intermediate intensity and gadolinium enhancement on T1-weighted images (WI) and high intensity on T2-WI and T2 STAR-WI. After undergoing computed tomography-guided needle biopsy, a pathological diagnosis of PVNS was made and total gross resection was performed.

Results: The gross appearance and the postoperative pathological diagnosis were consistent with PVNS. The postoperative clinical course was uneventful and postoperative computed tomography and magnetic resonance imaging revealed no residual lesion.

Conclusion: This is the first report of PVNS occurring in spondylolysis.

Level of evidence: N/A.

Publication types

  • Case Reports

MeSH terms

  • Adolescent
  • Contrast Media
  • Female
  • Giant Cell Tumor of Bone / diagnostic imaging
  • Giant Cell Tumor of Bone / pathology*
  • Giant Cell Tumor of Bone / surgery
  • Humans
  • Image-Guided Biopsy
  • Low Back Pain / diagnostic imaging
  • Low Back Pain / etiology
  • Low Back Pain / surgery
  • Lumbar Vertebrae / diagnostic imaging
  • Lumbar Vertebrae / pathology*
  • Lumbar Vertebrae / surgery
  • Magnetic Resonance Imaging
  • Predictive Value of Tests
  • Spinal Neoplasms / diagnostic imaging
  • Spinal Neoplasms / pathology*
  • Spinal Neoplasms / surgery
  • Spondylolysis / diagnostic imaging
  • Spondylolysis / pathology*
  • Spondylolysis / surgery
  • Synovitis, Pigmented Villonodular / pathology*
  • Tomography, X-Ray Computed
  • Treatment Outcome


  • Contrast Media