Pigmented Villonodular Tenosynovitis Involving the Fourth Toe: Report of an Uncommon Case
Ganesh S Dharmshaktu, Ishwar S Dharmshaktu, Tanuja Pangtey
Keywords :
Benign lesion, Biopsy, Case report, Foot, Lump, Mass, Pigmented villonodular tenosynovitis, Tenosynovitis, Toe
Citation Information :
Dharmshaktu GS, Dharmshaktu IS, Pangtey T. Pigmented Villonodular Tenosynovitis Involving the Fourth Toe: Report of an Uncommon Case. J Foot Ankle Surg Asia-Pacific 2024; 11 (3):142-146.
Background: Pigmented villonodular synovitis (PVNS) is an uncommon entity that mostly involves larger joints like the knee and hip. The condition presents with synovial thickening and proliferation into the growth of the variable sizes, and the exact etiology is still not clear. Pigmented villonodular tenosynovitis (PVNTS), a variant, is the condition arising from the tendinous tissues. Its presentation as a lump over a singular toe is a rare occurrence.
Case description: We hereby report a case of a mass over the left fourth toe of a young lady, with minimal clinical complaints except for difficulty in wearing footwear. Magnetic resonance imaging (MRI) was followed by excision biopsy, leading to the final diagnosis of PVNTS. Uneventful healing of the wound and no complication or recurrence were noted in the follow-up of 13 months.
Conclusion: Mass lesions may occasionally present at unusual sites and require histopathological evaluation for an appropriate diagnosis.
Clinical significance: Pigmented villonodular tenosynovitis should be kept as an uncommon differential diagnosis in cases of the lump affecting the foot and ankle region.
Sharma H, Jane MJ, Reid R. Pigmented villonodular synovitis of the foot and ankle: forty years of experience from the Scottish bone tumor registry. J Foot Ankle Surg 2006;45(5):329–336. DOI: 10.1053/j.jfas.2006.05.003
Edwards C, Milner S. Pigmented villonodular synovitis of second toe interphalangeal joint: methods of imaging. Foot Ankle Surg 2010;16(2):e34–e36. DOI: 10.1016/j.fas.2009.05.015
Rochwerger A, Groulier P, Curvale G, et al. Pigmented villonodular synovitis of the foot and ankle: a report of eight cases. Foot Ankle Int 1999;20(9):587–590. DOI: 10.1177/107110079902000909
Murphey MD, Rhee JH, Lewis RB, et al. Pigmented villonodular synovitis: radiologic-pathologic correlation. RadioGraphics 2008;28(5):1493–1518. DOI: 10.1148/rg.285085134
Rao AS, Vigorita VJ. Pigmented villonodular synovitis (giant-cell tumor of the tendon sheath and synovial membrane). A review of eighty-one cases. J Bone Joint Surg 1984;66(1):76–94. PMID: 6317696.
Kinra P, Varghese BK. Pigmented villonodular synovitis: dorsum foot. Med J Armed Forces India 2007;63(3):294–296. DOI: 10.1016/S0377-1237(07)80163-8
Bisbinas I, De Silva U, Grimer RJ. Pigmented villonodular synovitis of the foot and ankle: a 12-year experience from a tertiary orthopaedic oncology unit. J Foot Ankle Surg 2004;43(6):407–411. DOI: 10.1053/j.jfas.2004.09.002
Berger I, Ehemann V, Helmchen B, et al. Comparative analysis of cell populations involved in the proliferative and inflammatory processes in diffuse and localized pigmented villonodular synovitis. Histol Histopathol 2004;19(3):687–692. DOI: 10.14670/HH-19.687
Krishna D, Kumar V, Chand S, et al. Tenosynovial giant cell tumor of subtler joint: a case report with review of literature. J Orthop Traumatol Rehabil 2017;9(2):115–119. DOI: 10.4103/jotr.jotr_45_15
Sharma P, Tiwari V, Khan SA, et al. An unusual case of pigmented villo-nodular synovitis of the second toe: a case report and review of literature. Foot 2016;28:61–63. DOI: 10.1016/j.foot.2016.08.001
Okoro T, Isaac S, Ashford RU, et al. Pigmented villonodular synovitis of the talonavicular joint: a case report and review of the literature. Foot (Edinb) 2009;19(3):186–188. DOI: 10.1016/j.foot.2009.01.006
Elahifar O, Torkaman, A, Ghaeini M, et al. Unusual presentation of talonavicular joint pigmented villonodular synovitis: a case report. J Med Case Rep 2024;18(1):60. DOI: 10.1186/s13256-024-04385-7
Rialson JA, Heit EJ. Second metatarsophalangeal joint pigmented villonodular synovitis: a case report. Foot Ankle Online J 2011;4(9):2. DOI: 10.3827/faoj.2011.0409.0002
Carpintero P, Gascon E, Mesa M, et al. Clinical and radiologic features of pigmented villonodular synovitis of the foot: report of eight cases. J Am Podiatr Med Assoc 2007;97(5):415–419. DOI: 10.7547/0970415
Duncan N, Rajan R. Case report of pigmented villonodular synovitis arising from the calcaneocuboid joint in a 12 year old male. Foot (Edinb) 2015;25(1):59–61. DOI: 10.1016/j.foot.2014.11.003
Lunawat A, Mehta D, Datey S, et al. Pigmented villonodular synovitis great toe. Indian J Surg 2013;75(Suppl 1):373–375. DOI: 10.1007/s12262-012-0715-1
Kokoszka P, Woźniak W, Łapaj Ł, et al. Pigmented villonodular synovitis - various manifestations, inconsistent terminology and treatment. cases study. Orthop Traumatol Rehabil 2017;19(1):79–88. DOI: 10.5604/15093492.1235281
Guo Q, Shi W, Jiao C, et al. Results and recurrence of pigmented villonodular synovitis of the ankle: dos diffuse PVNS with extra-articular extension tend to recur more often. Knee Sports Surg Trauma Arthrosc 2018;26(10):3118–3123. DOI: 10.1007/s00167-017-4488-8
Zampeli F, Giotis D, Mentellos G, et al. Intra-articular post-traumatic ankle joint mass imitating localised pigmented villonodular synovitis (LPVS), the aid of ankle arthroscopy for diagnosis and treatment- a case report. Foot (Edinb) 2015;25(1):51–54. DOI: 10.1016/j.foot.2015.01.001
Rana R, Behera S, Jeetendra C. Pigmented villonodular synovitis of flexor hallucinations longs, flexor digitorum longus, tibialis posterior: a rare case report. Cureus 2022;14(4):e24595. DOI: 10.7759/cureus.24595
Lee M, Mahroof S, Pringle J, et al. Diffuse pigmented villonodular synovitis of the foot and ankle treated with surgery and radiotherapy. Int Orthop 2005;29(6):403–405. DOI: 10.1007/s00264-005-0004-8
Brien EW, Sacoman DM, Mirra JM. Pigmented villonodular synovitis of the foot and ankle. Foot Ankle Int 2004;25(12):908–913. DOI: 10.1177/107110070402501211
Stevenson JD, Jaiswal A, Gregory JJ, et al. Diffuse pigmented villonodular synovitis(diffuse-type giant cell tumour) of the foot and ankle. Bone Joint J 2013;95-B(3):384–390. DOI: 10.1302/0301-620X.95B3.30192
Bertoni F, Unni KK, Beabout J, et al. Malignant giant cell tumor of the tendon sheaths and joints (malignant pigmented villonodular synovitis). Am J Sure Pathol 1997;21(2):153–163. DOI: 10.1097/00000478-199702000-00004
Khurana A, Singh JP, Preeti, et al. Demystifying giant cell tumours of tendon sheath (GCTTS): a case series of 18 cases with review of literature. Indian J Orthop 2023;57(11):1858–1873. DOI: 10.1007/s43465-023-00990-8
Pannu CD, Morey V, Prashant B, et al. Pigmented villonodular synovitis of 1st metatarsophalangeal joint: a case report and literature review. Foot (Edinb) 2014;24(3):146–148. DOI: 10.1016/j.foot.2014.05.001
Martin RC 2nd, Osborne DL, Edwards MJ, et al. Giant cell tumor of tendon sheath, tenosynovial giant cell tumor, and pigmented villonodular synovitis: defining the presentation, surgical therapy and recurrence. Oncol Rep 2000;7(2):413–419. DOI: 10.3892/or.7.2.413
Zendeoui A, Gharbi MA, Nafiss M, et al. Giant cell tumor of the tendon sheath of the toe: case report of an unusual location. Int J Surg Case Rep 2023;102:107797. DOI: 10.1016/j.ijscr.2022.107797
Nathani G, Swamy A, Bhamare DS. Localized pigmented villonodular synovitis of talocalcaneal joint: a rare case report. Indian J Orthop Surg 2019;5(4):275–277. DOI: 10.18231/j.ijos.2019.055