Factors for Recurrence in Pigmented Villonodular Synovitis of Large Joints / 대한정형외과학회잡지

ABSTRACT

PURPOSE: Pigmented villonodular synovitis (PVNS) is a rare proliferative disorder of the synovium, and this can affect the joints, tendon sheaths or bursae. PVNS is histologically benign, but it has a high propensity for local recurrence. The purpose of this study is to identify the clinical and pathological factors that are associated with local recurrence of PVNS. MATERIALS AND METHODS: Fifty-one patients with biopsy-proven PVNS were retrospectively reviewed. There were 20 men and 31 women with an average age of 34 years (range 12-73). The average follow-up period was 4.1 years (range 1-25 years). All lesions were located in large joints (knee 25, ankle 11, hip 7, foot 5, wrist 2, elbow 1). Of the 51 lesions in the large joints, 39 were the diffuse type and 12 were the localized type. The initial clinical presentation was pain or a painful mass in 32 patients and a painless mass in 19 patients. Complete surgical removal of the lesion was performed in 39 cases, whereas incomplete excision was performed in 12. No adjuvant therapy was given in any cases. RESULTS: Sixteen local recurrences (31%) developed at an average of 24 months (range, 4-96). Factors related to local recurrence in the large joints were incomplete surgical removal (p < 0.001), diffuse type of the lesion (p=0.049) and the presence of bone erosion (p=0.037) CONCLUSION: In cases of PVNS in large joints, the factors that increased the local recurrence rate were incomplete surgical removal, diffuse type lesion and the presence of bone erosion.