Pigmented Villonodular Synovitis Around the Elbow Joint That Required Upper Arm Amputation

Area of Science:

• Orthopedic Surgery
• Oncology
• Pathology

Background:

• Pigmented villonodular synovitis (PVNS) is a rare, benign neoplastic proliferation of the synovium.
• While commonly affecting the knee, PVNS can occur in other joints, presenting unique surgical challenges.

Observation:

• A 74-year-old female presented with a large (8x5 cm) olecranon mass and elbow pain.
• The patient had a history of giant cell tumor resection in the same region and chronic renal failure with a shunt.
• MRI revealed a large tumor with characteristic signal intensities, complicating limb preservation.

Findings:

• The extensive tumor size and presence of a vital vascular shunt necessitated upper arm amputation.
• Histological examination confirmed the diagnosis of pigmented villonodular synovitis (PVNS).
• No recurrence was noted postoperatively, underscoring the importance of radical resection.

Implications:

• This case underscores the aggressive potential of PVNS and the critical need for complete surgical excision.
• Limb salvage may be challenging in cases of large PVNS with critical vascular involvement.
• Careful postoperative follow-up is essential for managing PVNS recurrence and ensuring optimal patient outcomes.