Localized Pigmented Villonodular Synovitis in the Shoulder: Report of a Case Treated through Arthroscopy

Pigmented villonodular synovitis (PVNS) is rare in the shoulder, with few descriptions in the literature. We present the case of a 58-year-old female patient with no history of trauma. The patient reported pain for 2 months with no limb irradiation and presented lifting strength loss and progressive limitation of active and passive mobility. She underwent unsupervised physical therapy and there was no improvement in symptoms. A magnetic resonance imaging (MRI) scan of the shoulder showed an oval structure of approximately 2 cm in diameter in the anteroinferior region of the glenohumeral joint with internal hypointense signal foci. We performed the arthroscopic treatment, with marginal resection of the lesion and tenotomy of the long bicipital head. The anatomopathological report confirmed the diagnosis of PVNS. Four years and five months after the surgery, the patient is pain-free, with full recovery of the left shoulder function. A follow-up MRI showed no recurrence, demonstrating the effectiveness of the arthroscopic treatment in this case.