Pigmented villonodular synovitis with chondroid metaplasia, resembling chondroblastoma of the bone: a report of three cases.

Department of Anatomic Pathology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
Modern Pathology (Impact Factor: 6.36). 06/2007; 20(5):545-51. DOI: 10.1038/modpathol.3800770
Source: PubMed

ABSTRACT We herein describe three cases of pigmented villonodular synovitis with chondroid metaplasia. Two cases involved the temporomandibular joint, whereas the remaining one case occurred in the hip joint. Histologically, the tumors showed a villous pattern and were mainly composed of histiocyte-like cells and scattered osteoclast-like multinucleated giant cells, accompanied by chondroid areas with occasional lace-like calcification. These features resembled those of chondroblastoma of the bone, with the exception of the villous pattern. The histiocyte-like cells showed positive immunoreactivity for CD68, whereas they were negative for S-100 protein. Some of the previously reported cases of chondroblastoma in the temporal bone may have actually been cases of pigmented villonodular synovitis with chondroid metaplasia. When histologically chondroblastoma-like lesions involve the temporal bone or temporomandibular joint, the possibility of pigmented villonodular synovitis with chondroid metaplasia should also be considered, in addition to chondroblastoma of the bone. The correlation between this lesion and synovial chondromatosis remains uncertain.

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    ABSTRACT: Objective: Pigmented villonodular synovitis (PVNS) is a benign proliferation of tissues within a joint. It most frequently affects large joints but it is rarely diagnosed at the temporomandibular joint (TMJ). Radical excision with wide margins is the most accepted treatment modality. PVNS is resistant to radiotherapy. Herein we report a case involving the TMJ causing pain and trismus and its management that appears to be successful. Study Design: A case report Methods: A 74 year old female presented to our clinic complaining of a right pre-auricular mass that she noticed for a couple of years. The mass was growing slowly and never bothered her till recently. She started to have pain with jaw opening. Also, trismus became more pronounced. CT-neck with intravenous contrast showed an enhancing mass surrounding the right mandibular condyle, with expansion of the temporomandibular joint. CT-guided biopsy of the right TMJ confirmed the diagnosis of PVNS. Results: Patient underwent tracheostomy, right superficial parotidectomy followed by right condylectomy and partial mandibulectomy. Intraoperatively, the tumor was destroying the condyle and invading the meniscus, masseter and pterygoid muscles and extending medially toward the skull base. Histologically, PVNS-diffuse type was confirmed in the specimen with negative margins. Postoperatively, patient developed a transient facial paralysis while pain and trismus disappeared. Conclusions: PVNS is a rare lesion in the TMJ. Pre-auricular mass is the most common presenting symptom. CT-guided biopsy along with CT-neck is crucial in the workup. Resection of the lesion with wide margin is the recommended treatment. Facial paralysis is a complication of the surgical treatment but it is usually shortly-lived.
    The Laryngoscope 01/2009; 119(S1). DOI:10.1002/lary.20369 · 2.03 Impact Factor
  • Annales de Pathologie 11/2007; 27:105–108. DOI:10.1016/S0242-6498(07)92886-2 · 0.29 Impact Factor
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    Revista Espanola de Cirugia Oral y Maxilofacial 02/2015; 10. DOI:10.1016/j.maxilo.2014.11.003


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