Diffused Pigmented Vilonodular Synovitis / Diffuse Type Tenosynovial Giant Cell Tumour of the knee treated with arthroscopic synovectomy and adjuvant Yttrium local infiltration. A case report, a “safe treatment algorithm” and the peer literature

  • Konstantinos G. Liosis
  • Vasileios N. Samdanis
  • Vasileios Prasopoulos
  • Spyridon Giarmenitis
  • Dimitrios Papaioannou
  • Ioannis K. Triantafyllopoulos
Keywords: Pigmented Villonodular Synovitis, Arthroscopic Synovectomy, Biological factors, Yttrium-90 infiltration


Pigmented villonodular synovitis (PVNS) is a unique mesenchymal lesion that arises from the synovial tissue of the joints. It is divided into a localized type (LPVNS) and a diffuse type (LPVNS) also known as Tenosynovial Giant Cell Tumor. The latter, is a predominantly intra-articular, aggressive, infiltrative process, characterized by both inflammatory or neoplastic properties and local destructive progression.  A high recurrence rate is observed after surgical synovectomy alone. The positivity of colony-stimulated factor 1 (CSF1), its receptor (CSF1R), and receptor activator of nuclear factor kappa-B ligand (RANKL) with the clinical outcomes and the recurrence rates is a field of interest in therapeutic targeting with the use of biological factors/agents such as anti-TNFa.  Adjuvant intra-articular injection of Yttrium-90 in the immediate post-operative period effectively reduces the rates of local recurrence. We present the case of a 59-year-old female patient with diffuse PVNS of the left knee treated with arthroscopic synovectomy and adjuvant Yttrium-90 local infiltration following a “safe treatment algorithm”.


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Author Biographies

Konstantinos G. Liosis

5th Orthopedic Department, HYGEIA Hospital, Athens, Greece

Vasileios N. Samdanis

5th Orthopedic Department, HYGEIA Hospital, Athens, Greece

Vasileios Prasopoulos

Department of Nuclear Medicine, HYGEIA Hospital, Athens, Greece

Spyridon Giarmenitis

Department of Radiology, HYGEIA Hospital, Athens, Greece

Dimitrios Papaioannou

Department of Pathology, HYGEIA Hospital, Athens, Greece

Ioannis K. Triantafyllopoulos

5th Orthopedic Department, HYGEIA Hospital, Athens, Greece


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