Purpose Of Review: Pigmented villonodular synovitis (PVNS) or tenosynovial giant cell tumor (TGCT) encompasses a wide spectrum of disease and is divided into localized and diffuse variants. Surgical resection remains the principal treatment for nearly all localized type disease and most diffuse type. Recent mechanistic understanding of the disease led to drug discovery that has opened new avenues for patients with recalcitrant disease. In this manuscript, we review the current treatment options for TGCT, presenting outcomes from traditional surgical approaches as well as those from nonsurgical approaches.
Recent Findings: Arthroscopic and/or open surgery remains the mainstay of treatment for TGCT for the vast majority of patients. While radiosynoviorthesis and external beam radiation have been used for recalcitrant disease, recent understanding of the colony stimulating factor 1 receptor (CSF1R) pathway and its paracrine and autocrine role in TGCT has led to the development of targeted inhibitors. Their optimal role and efficacy are unclear due to limited number of high-quality studies and contradictory results; however, recent and ongoing studies suggest there may be a role for their use, especially in diffuse and/or refractory disease. Surgery remains the most common treatment for TGCT, however, there may be an increasing role for adjuvant therapies, including the new targeted agents. Weighing the side effects of these treatments against the symptomatic benefit on a patient-by-patient basis in this benign disease remains critical.
Tenosynovial giant cell tumors (TGCTs) are aggressive tumors often found in younger individuals, leading to long-term disability and typically managed via surgery, which has its own risks.
This review focuses on systemic treatment options, particularly for the diffuse subtype (DT-TGCT), and assesses recent advancements and the historical context of these therapies.
Notable progress includes the development of CSF1 receptor-targeting therapies like pexidartinib, paving the way for further research on treatment effectiveness and optimizing patient outcomes.
Pigmented villonodular synovitis (PVNS) is an uncommon hyperproliferative disease of the synovium presenting either as localized or a more aggressive diffuse form. Its occurrence following total knee arthroplasty (TKA) is rare, and its presentation alongside patellar clunk syndrome (PCS) has not been previously reported. We present a case of a 64-year-old female patient diagnosed with diffuse PVNS (D-PVNS) two and half years following TKA, co-occurring with PCS.
The Achilles tendon is the strongest and largest tendon in the human body, composed of the distal confluence of the gastrocnemius and soleus muscles and may also include the plantaris longus tendons. Despite its tremendous strength, it is frequently injured. Soft tissue tumors or tumor-like conditions of Achilles tendon are much less common in comparison to traumatic and infectious/inflammatory lesions.
Pigmented villonodular synovitis (PVNS) is a rare neoplastic proliferation of large joints, including the knee, with both localized PVNS (LPVNS) and diffuse PVNS (DPVNS) types. DPVNS is known to recur at a higher rate following resection; however, there is little evidence comparing patient-reported outcomes (PROs) between the two types. The purpose of this study was to compare PROs between patients with LPVNS and DPVNS involving the knee 2 years after surgical resection.
