Skip to main content

Tenosynovial Giant Cell Tumor

  • Chapter
  • First Online:
Imaging of Synovial Tumors and Tumor-like Conditions

Abstract

Tenosynovial giant cell tumor is a family of lesions usually involving the joint, bursae, and/or tendon sheath synovia. Tenosynovial giant cell tumor includes two subtypes, localized and diffuse, that are histologically similar, but have disparate clinical and imaging features. Diffuse tenosynovial giant cell tumor most frequently affects the large joints, while localized forms involve the hand or wrist. Radiography shows nonspecific features such as maintained joint space, joint effusion, and extrinsic erosion on both sides of the joint space. MR imaging demonstrates the disease extent and depicts the blooming artifact from hemosiderin deposition. Diagnosis always requires MRI, and often histologic confirmation is needed. Indications and modalities of treatment are discussed according to symptomatology, progression, and location.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 119.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Hardcover Book
USD 159.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Abbreviations

CT:

Computed tomography

DTGCT:

Diffuse tenosynovial giant cell tumor

FDG PET/CT:

Fluorodeoxyglucose-positron emission computed tomography

LTGCT:

Localized tenosynovial giant cell tumor

MRI:

Magnetic resonance imaging

TGCT:

Tenosynovial giant cell tumor

References

  • Abdelwahab I, Kenan S, Steiner GC, Abdul-Quader M (2002) True bursal pigmented villonodular synovitis. Skeletal Radiol 31:354–358

    PubMed  Google Scholar 

  • Baker ND, Klein JD, Weidner N, Weissman BN, Brick GW (1989) Pigmented villonodular synovitis containing coarse calcifications. AJR Am J Roentgenol 153:1228–1230

    CAS  PubMed  Google Scholar 

  • Becce F, Federau C, Letovanec I, Grandjean A, So AK, Rüdiger HA (2015) Dual-energy computed tomography molecular imaging of pigmented villonodular synovitis. Rheumatology (Oxford) 54(3):457. https://doi.org/10.1093/rheumatology/keu473. Epub 2014 Dec 11. PMID: 25504960

    Article  PubMed  Google Scholar 

  • Bemporad JA, Chaloupka JC, Putman CM et al (1999) Pigmented villonodular synovitis of the temporomandibular joint: diagnostic imaging and endovascular therapeutic embolization of a rare head and neck tumor. AJNR Am J Neuroradiol 20:159–162

    CAS  PubMed  Google Scholar 

  • Bhimani MA, Wenz JF (2001) Pigmented villonodular synovitis: keys to early diagnosis. Clin Orthop 386:197–202

    Google Scholar 

  • Bravo SM, Winalski CS, Weissman BN (1996) Pigmented villonodular synovitis. Radiol Clin North Am 34:311–326

    CAS  PubMed  Google Scholar 

  • Campanacci M (1999) Bone and soft tissue tumors: clinical features, imaging, pathology and treatment. Springer. ISBN 978-3-7091-3848-9

    Google Scholar 

  • Carpintero P, Gascon E, Mesa M, Jimenez C, Lopez U (2007) Clinical and radiologic features of pigmented villonodular synovitis of the foot: report of eight cases. J Am Podiatr Med Assoc 97:415–419

    PubMed  Google Scholar 

  • Cassier P, Gelderblom H, Stacchiotti S, Thomas D, Maki R, Kroep J et al (2012) Efficacy of Imatinib Mesylat for the treatment of locally advanced and/or metastatic tenosynovial giant cell tumor/pigmented villonodular synovitis. Cancer 15:1649–1656

    Google Scholar 

  • Cassier P, Italiano A, Gomez-Roca CA, Le Tourneau C, Toulmonde M, Cannarile MA et al (2015) CSF1R inhibition with emactuzumab in locally advanced diffuse-type tenosynovial giant cell tumours of the soft-tissue: a dose-escalation and dose-expansion phase 1 study. Lancet Oncol 16:949–956

    CAS  PubMed  Google Scholar 

  • Chung SM, Janes JM (1965) Diffuse pigmented villonodular synovitis of the hip joint. Review of the literature and report of four cases. J Bone Joint Surg Am 47:293–303

    CAS  PubMed  Google Scholar 

  • de Saint Aubain Somerhausen N, van de Rijn M (2013) Tenosynovial giant cell tumour, diffuse type. In: Fletcher CDM, Bridge J, Hogendoorn P, Mertens F (eds) World Health Organization classification of tumours of soft tissue and bone, 4th edn. IARC Press, Lyon, p 102e3

    Google Scholar 

  • Dorfman HD, Czerniak B (1998) Synovial lesions. In: Bone tumors. Mosby, St Louis, MO, pp 1061–1071

    Google Scholar 

  • Dorwart RH, Genant HK, Johnston WH, Morris JM (1984) Pigmented villonodular synovitis of synovial joints: clinical, pathologic, and radiologic features. AJR Am J Roentgenol 143:877–885

    CAS  PubMed  Google Scholar 

  • Dundar A, Young JR, Wenger DE et al (2020) Unusual manifestations of diffuse-type tenosynovial giant cell tumor in two patients: importance of radiologic-pathologic correlation. Skeletal Radiol 49:483–489

    PubMed  Google Scholar 

  • Enzinger FM, Weiss SW (2008) Soft tissue tumors, 4th edn. Mosby, St Louis, MO, pp 1054–1056

    Google Scholar 

  • Flandry F, Hughston JC (1987) Pigmented villonodular synovitis. J Bone Joint Surg Am 69:942–949

    CAS  PubMed  Google Scholar 

  • Flipo RM, Chastanet P, Duquesnoy B (1993) Imaging of pigmented villonodular synovitis. Presse Med 22:591–594

    CAS  PubMed  Google Scholar 

  • Furlong MA, Motamedi K, Laskin WB et al (2003) Synovial-type giant cell tumors of the vertebral column: a clinicopathologic study of 15 cases, with a review of the literature and discussion of the differential diagnosis. Hum Pathol 34:670–679

    PubMed  Google Scholar 

  • Garner HW, Ortiguera CJ, Nakhleh RE (2008) Pigmented villonodular synovitis. Radiographics 28:1519–1523

    PubMed  Google Scholar 

  • Ge Y, Guo G, You Y, Li Y, Xuan Y, Jin ZW, Yan G (2019) Magnetic resonance imaging features of fibromas and giant cell tumors of the tendon sheath: differential diagnosis. Eur Radiol 29(7):3441–3449

    PubMed  Google Scholar 

  • Goldman AB, DiCarlo EF (1988) Pigmented villonodular synovitis, diagnosis and differential diagnosis. Radiol Clin North Am 26:1327–1347

    CAS  PubMed  Google Scholar 

  • Gupta S, Mishra RS (2002) Cytologic appearance of pigmented villonodular synovitis. A case report. Acta Cytol 46(4):728–730. https://doi.org/10.1159/000326984. PMID: 12146040

    Article  PubMed  Google Scholar 

  • Huang GS, Lee CH, Chan WP, Chen CY, Yu JS, Resnick D (2003) Localized nodular synovitis of the knee: MR imaging appearance and clinical correlates in 21 patients. AJR Am J Roentgenol 181:539–543

    PubMed  Google Scholar 

  • Hughes TH, Sartoris DJ, Schweitzer ME, Resnick DL (1995) Pigmented villonodular synovitis: MRI characteristics. Skeletal Radiol 24:7–12

    CAS  PubMed  Google Scholar 

  • Jelinek JS, Kransdorf MJ, Utz JA et al (1989) Imaging of pigmented villonodular synovitis with emphasis on MR imaging. AJR Am J Roentgenol 152:337–342

    CAS  PubMed  Google Scholar 

  • Karasick D, Karasick S (1992) Giant cell tumor of tendon sheath: spectrum of radiologic findings. Skeletal Radiol 21:219–224

    CAS  PubMed  Google Scholar 

  • Kempson RL, Fletcher CDM, Evans HL, Hendrickson MR, Sibley RK (2001) Synovial tumors. In: Atlas of tumor pathology: tumors of the soft tissues, vol 138, 3rd edn. Armed Forces Institute of Pathology, Washington, DC, pp 387–394

    Google Scholar 

  • Kim S-J et al (2000) Arthroscopic treatment for localized pigmented villonodular synovitis of the knee. Clin Orthop 379:224–230

    Google Scholar 

  • Kransdorf MJ, Murphey MD (2006) Synovial tumors. In: Imaging of soft tissue tumors. Lippincott Williams & Wilkins, Philadelphia, PA, pp 381–436

    Google Scholar 

  • Ladeb MF, Chelli Bouaziz M, Riahi H, Mechri M (2020) Echographie des tumeurs et pseudo-tumeurs synoviales. In: Actualités en échographie de l'appareil locomoteur, vol 16. Sauramps, pp 359–374

    Google Scholar 

  • Lang N, Yuan HS (2015) Computed tomography and magnetic resonance manifestations of spinal pigmented villonodular synovitis. J Comput Assist Tomogr 39(4):601–606. https://doi.org/10.1097/RCT.0000000000000244. PMID: 25836023

    Article  PubMed  Google Scholar 

  • Lazarou I, D’Agostino MA, Naredo E, Humby F, Filer A, Kelly SG (2015) Ultrasound-guided synovial biopsy: a systematic review according to the OMERACT filter and recommendations for minimal reporting standards in clinical studies. Rheumatology 54(10):1867–1875

    PubMed  Google Scholar 

  • Le WJ, Li MH, Shi HM (2014) Pigmented villonodular synovitis of the temporomandibular joint: CT imaging findings. Clin Imaging 38:6–10

    PubMed  Google Scholar 

  • Lin J, Jacobson JA, Jamadar DA, Ellis JH (1999) Pigmented villonodular synovitis and related lesions: the spectrum of imaging findings. AJR Am J Roentgenol 172(1):191–197. https://doi.org/10.2214/ajr.172.1.9888766. PMID: 9888766

    Article  CAS  PubMed  Google Scholar 

  • Lindenbaum BL, Hunt T (1977) An unusual presentation of pigmented villonodular synovitis. Clin Orthop Relat Res 122:263–267

    Google Scholar 

  • Llauger J, Palmer J, Roson N et al (1999) Pigmented villonodular synovitis and giant cell tumors of the tendon sheath: radiologic and pathologic features. AJR Am J Roentgenol 172:1087–1091

    CAS  PubMed  Google Scholar 

  • Llauger J, Palmer J, Rosón N, Bagué S, Camins A, Cremades R (2000) Nonseptic monoarthritis: imaging features with clinical and histopathologic correlation. Radiographics 20 Spec No:S263–S278. https://doi.org/10.1148/radiographics.20.suppl_1.g00oc13s263. PMID: 11046178

    Article  CAS  PubMed  Google Scholar 

  • Martinoli C, Bianchi S, Derchi LE (1999) Tendon and nerve sonography. Radiol Clin North Am 37:691–711

    CAS  PubMed  Google Scholar 

  • Middleton WD, Patel V, Teefey SA, Boyer MI (2004) Giant cell tumors of the tendon sheath: analysis of sonographic findings. AJR Am J Roentgenol 183:337–339

    PubMed  Google Scholar 

  • Murphey MD, Rhee JH, Lewis RB, Fanburg-Smith JC, Flemming DJ, Walker EA (2008) Pigmented villonodular synovitis: radiologic-pathologic correlation. Radiographics 28(5):1493–1518

    PubMed  Google Scholar 

  • Muscolo DL, Makino A, Costa-Paz M, Ayerza M (2000) Magnetic resonance imaging evaluation and arthroscopic resection of localized pigmented villonodular synovitis of the knee. Orthopedics 23:367–369

    CAS  PubMed  Google Scholar 

  • Myers BW, Masi AT (1980) Pigmented villonodular synovitis and tenosynovitis: a clinical epidemiologic study of 166 cases and literature review. Medicine (Baltimore) 59:223–238

    CAS  PubMed  Google Scholar 

  • O’Sullivan B, Cummings B, Catton C et al (1995) Outcome following radiation treatment for high-risk pigmented villonodular synovitis. Int J Radiat Oncol Biol Phys 32:777–786

    PubMed  Google Scholar 

  • Ofluoglu O (2006) Pigmented villonodular synovitis. Orthop Clin North Am 37:23–33

    PubMed  Google Scholar 

  • Peh WC, Wong Y, Shek TW, Ip WY (2001) Giant cell tumour of the tendon sheath of the hand: a pictorial essay. Australas Radiol 45:274–280

    CAS  PubMed  Google Scholar 

  • Roguski M, Safain MG, Zerris VA et al (2014) Pigmented villonodular synovitis of the thoracic spine. J Clin Neurosci 21:1679–1685

    PubMed  Google Scholar 

  • Rydholm U (1998) How I do it: pigmented villonodular synovitis. Acta Orthop Scand 69:203–210

    CAS  PubMed  Google Scholar 

  • Schvartzman P, Carrozza V, Pascual T, Mazza L, Odesser M, San Román JL (2015) Radiological features of pigmented villonodular synovitis and giant cell tumor of the tendon sheath. Rev Argent Radiol 79(1):4–11

    Google Scholar 

  • Schwartz HS, Unni KK, Pritchard DJ (1989) Pigmented villonodular synovitis: a retrospective review of affected large joints. Clin Orthop Relat Res 247:243–255

    Google Scholar 

  • Scott PM (1968) Bone lesions in pigmented villonodular synovitis. J Bone Joint Surg Br 50:306–311

    CAS  PubMed  Google Scholar 

  • Shabat S, Kollender Y, Merimsky O et al (2002) The use of surgery and yttrium 90 in the management of extensive and diffuse pigmented villonodular synovitis of large joints. Rheumatology (Oxford) 41:1113–1118

    CAS  PubMed  Google Scholar 

  • Sharma H, Rana B, Mahendra A, Jane MJ, Reid R (2007) Outcome of 17 pigmented villonodular synovitis (PVNS) of the knee at 6 years mean follow-up. Knee 14:390–394

    CAS  PubMed  Google Scholar 

  • Sitt JC, Griffith JF, Wong P (2016) Ultrasound-guided synovial biopsy. Br J Radiol 89(1057):20150363

    PubMed  Google Scholar 

  • Sullivan CJ, Eustace SJ, Kavanagh EC (2020) Pigmented villonodular synovitis of the hip joint: three cases demonstrating characteristic MRI features. Radiol Case Rep 15(8):1335–1338. https://doi.org/10.1016/j.radcr.2020.05.067. PMID: 32617126; PMCID: PMC7322487

    Article  PubMed  PubMed Central  Google Scholar 

  • Ushijima M, Hashimoto H, Tsuneyoshi M, Enjoli M (1986) Giant cell tumor of the tendon sheath (nodular tenosynovitis). A study of 207 cases to compare the large joint group with common digit group. Cancer 57:875–884

    CAS  PubMed  Google Scholar 

  • Vastel L, Lambert P, De Pinieux G, Charrois O, Kerboull M, Courpied JP (2005) Surgical treatment of pigmented villonodular synovitis of the hip. J Bone Joint Surg Am 87:1019–1024

    PubMed  Google Scholar 

  • Vigorita VI (1984) Pigmented villonodular synovitis-like lesions in association with rare cases of rheumatoid arthritis, osteonecrosis and advanced degenerative joint disease. Report of five cases. Clin Orthop 183:115–121

    Google Scholar 

  • West RB, Rubin BP, Miller MA et al (2006) A landscape effect in tenosynovial giant-cell tumor from activation of CSF1 expression by a translocation in a minority of tumor cells. Proc Natl Acad Sci U S A 103:690e5

    Google Scholar 

  • White ML, Johnson GB, Howe BM, Peller PJ, Broski SM (2016) Spectrum of benign articular and periarticular findings at FDG PET/CT. Radiographics 36(3):824–839. https://doi.org/10.1148/rg.2016150100. PMID: 27163594

    Article  PubMed  Google Scholar 

  • Wu CC, Pritsch T, Bickels J, Wienberg T, Malawer MM (2007) Two incision synovectomy and radiation treatment for diffuse pigmented villonodular synovitis of the knee with extra-articular component. Knee 14:99–106

    CAS  PubMed  Google Scholar 

  • Young-in LF et al (1998) Discrete soft tissue mass in the distal thigh of a 29 years old man. Clin Orthop 357:247–250

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Hend Riahi .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2023 The Author(s), under exclusive license to Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Riahi, H., Ladeb, M.F., Chelli Bouaziz, M. (2023). Tenosynovial Giant Cell Tumor. In: Vanhoenacker, F.M., Ladeb, M.F. (eds) Imaging of Synovial Tumors and Tumor-like Conditions. Medical Radiology(). Springer, Cham. https://doi.org/10.1007/174_2023_415

Download citation

  • DOI: https://doi.org/10.1007/174_2023_415

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-031-33634-8

  • Online ISBN: 978-3-031-33635-5

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics