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Pigmented Villonodular Synovitis Presenting as a Popliteal Cyst.

Nikhil Gokhale1, Shaligam Purohit1, Pradeep B Bhosale1

  • 1Department of Orthopaedic, KEM hospital, Parel, Mumbai-12. India.

Journal of Orthopaedic Case Reports
|June 15, 2016
PubMed
Summary

Pigmented villonodular synovitis (PVNS) can rarely present as a popliteal cyst, mimicking other conditions. Early diagnosis and treatment of both intra-articular and extra-articular pathology are crucial for managing this uncommon condition.

Keywords:
ArthroscopicPigmented villonodular synovitisPopliteal cyst

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Area of Science:

  • Orthopedics
  • Pathology
  • Radiology

Background:

  • Pigmented villonodular synovitis (PVNS) is a rare condition affecting the synovium, often presenting with joint effusions and bone erosions.
  • PVNS can mimic other knee pathologies, making diagnosis challenging.
  • A popliteal cyst is a common presentation that can obscure intra-articular PVNS.

Observation:

  • A 12-year-old boy presented with a gradually enlarging popliteal mass and restricted knee flexion.
  • Initial clinical examination and imaging suggested a popliteal cyst or hematoma, with soft tissue sarcoma also considered.
  • An excisional biopsy revealed a cystic-nodular mass communicating with the knee joint, histologically confirmed as PVNS.

Findings:

  • Histopathological examination confirmed pigmented villonodular synovitis (PVNS) in both the popliteal mass and the intra-articular synovium.
  • Arthroscopic synovectomy successfully removed abnormal synovium from all knee compartments.

Implications:

  • Popliteal swellings require thorough investigation, including histopathological analysis, to rule out less common diagnoses like PVNS.
  • Effective treatment of PVNS involves addressing both the intra-articular and extra-articular components.
  • This case highlights the importance of considering PVNS in the differential diagnosis of popliteal cysts.