A Rare Case of Localized Pigmented Villonodular Synovitis of the Wrist presenting as Carpal Tunnel Syndrome
Introduction: A form of tenosynovial giant cell tumors (GCTs) that diffusely affects the soft tissue lining of joints and tendons is called pigmented villonodular synovitis or PVNS. About equal percentages of men and women are often affected, and it typically affects young individuals. The most typi...
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| Language: | English |
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Indian Orthopaedic Research Group
2025-01-01
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| Series: | Journal of Orthopaedic Case Reports |
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| Online Access: | https://jocr.co.in/wp/2025/01/01/a-rare-case-of-localized-pigmented-villonodular-synovitis-of-the-wrist-presenting-as-carpal-tunnel-syndrome/ |
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| author | Akash Sahu Aashiket Sable Sunil Yadav Nihar Parmar Anuj Gawankar |
| author_facet | Akash Sahu Aashiket Sable Sunil Yadav Nihar Parmar Anuj Gawankar |
| author_sort | Akash Sahu |
| collection | DOAJ |
| description | Introduction:
A form of tenosynovial giant cell tumors (GCTs) that diffusely affects the soft tissue lining of joints and tendons is called pigmented villonodular synovitis or PVNS. About equal percentages of men and women are often affected, and it typically affects young individuals. The most typical sites of PVNS are the knee and ankle, making PVNS of the wrist a rare presentation. Patients with PVNS might develop symptoms of carpal tunnel syndrome (CTS) and only a handful of cases are reported in the literature. The gold standard of treatment has traditionally been surgical excision for localized lesions and additional total synovectomy of the affected joint in cases of diffuse PVNS. The objective of this article is to present a patient with PVNS of the right wrist leading to CTS, resolved with surgical treatment which led to satisfactory results.
Case Report:
A 29-year-old right-hand dominant female patient arrived at our out-patient department with complaints of swelling, pain, tingling, and numbness of the right palm. The patient had similar complaints 1 year ago when carpal tunnel release surgery was done for her elsewhere. After 1 year of surgery, the symptoms persisted along with diffuse swelling. Clinical examination of the patient confirmed the presence of CTS. A tenosynovial mass around the flexor tendons located along the carpal tunnel at the level of the distal radioulnar joint was visible on magnetic resonance imaging. The median nerve’s conduction velocity was found to be lowered on electrodiagnostic testing. Total lesion excision was done along with carpal tunnel release, and the mass was excised and sent for histopathology. Histopathological evaluation of the extracted material confirmed the diagnosis of PVNS. At the 5-year follow-up, there were no complaints or indications of recurrence.
Conclusion:
Localized PVNS of the wrist presenting as CTS is a rare condition. To diagnose this illness, several investigations and a high index of suspicion are needed. Total excision of the lesion, along with surgical release of the carpal tunnel, should be ensured to avoid recurrence. |
| format | Article |
| id | doaj-art-67484ad29a4345f2811a28f87974c8c3 |
| institution | OA Journals |
| issn | 2250-0685 2321-3817 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Indian Orthopaedic Research Group |
| record_format | Article |
| series | Journal of Orthopaedic Case Reports |
| spelling | doaj-art-67484ad29a4345f2811a28f87974c8c32025-08-20T02:10:17ZengIndian Orthopaedic Research GroupJournal of Orthopaedic Case Reports2250-06852321-38172025-01-0115115515910.13107/jocr.2025.v15.i01.5160A Rare Case of Localized Pigmented Villonodular Synovitis of the Wrist presenting as Carpal Tunnel SyndromeAkash SahuAashiket SableSunil YadavNihar ParmarAnuj GawankarIntroduction: A form of tenosynovial giant cell tumors (GCTs) that diffusely affects the soft tissue lining of joints and tendons is called pigmented villonodular synovitis or PVNS. About equal percentages of men and women are often affected, and it typically affects young individuals. The most typical sites of PVNS are the knee and ankle, making PVNS of the wrist a rare presentation. Patients with PVNS might develop symptoms of carpal tunnel syndrome (CTS) and only a handful of cases are reported in the literature. The gold standard of treatment has traditionally been surgical excision for localized lesions and additional total synovectomy of the affected joint in cases of diffuse PVNS. The objective of this article is to present a patient with PVNS of the right wrist leading to CTS, resolved with surgical treatment which led to satisfactory results. Case Report: A 29-year-old right-hand dominant female patient arrived at our out-patient department with complaints of swelling, pain, tingling, and numbness of the right palm. The patient had similar complaints 1 year ago when carpal tunnel release surgery was done for her elsewhere. After 1 year of surgery, the symptoms persisted along with diffuse swelling. Clinical examination of the patient confirmed the presence of CTS. A tenosynovial mass around the flexor tendons located along the carpal tunnel at the level of the distal radioulnar joint was visible on magnetic resonance imaging. The median nerve’s conduction velocity was found to be lowered on electrodiagnostic testing. Total lesion excision was done along with carpal tunnel release, and the mass was excised and sent for histopathology. Histopathological evaluation of the extracted material confirmed the diagnosis of PVNS. At the 5-year follow-up, there were no complaints or indications of recurrence. Conclusion: Localized PVNS of the wrist presenting as CTS is a rare condition. To diagnose this illness, several investigations and a high index of suspicion are needed. Total excision of the lesion, along with surgical release of the carpal tunnel, should be ensured to avoid recurrence.https://jocr.co.in/wp/2025/01/01/a-rare-case-of-localized-pigmented-villonodular-synovitis-of-the-wrist-presenting-as-carpal-tunnel-syndrome/pigmented villonodular synovitiscarpal tunnel syndromecarpal tunnel release |
| spellingShingle | Akash Sahu Aashiket Sable Sunil Yadav Nihar Parmar Anuj Gawankar A Rare Case of Localized Pigmented Villonodular Synovitis of the Wrist presenting as Carpal Tunnel Syndrome Journal of Orthopaedic Case Reports pigmented villonodular synovitis carpal tunnel syndrome carpal tunnel release |
| title | A Rare Case of Localized Pigmented Villonodular Synovitis of the Wrist presenting as Carpal Tunnel Syndrome |
| title_full | A Rare Case of Localized Pigmented Villonodular Synovitis of the Wrist presenting as Carpal Tunnel Syndrome |
| title_fullStr | A Rare Case of Localized Pigmented Villonodular Synovitis of the Wrist presenting as Carpal Tunnel Syndrome |
| title_full_unstemmed | A Rare Case of Localized Pigmented Villonodular Synovitis of the Wrist presenting as Carpal Tunnel Syndrome |
| title_short | A Rare Case of Localized Pigmented Villonodular Synovitis of the Wrist presenting as Carpal Tunnel Syndrome |
| title_sort | rare case of localized pigmented villonodular synovitis of the wrist presenting as carpal tunnel syndrome |
| topic | pigmented villonodular synovitis carpal tunnel syndrome carpal tunnel release |
| url | https://jocr.co.in/wp/2025/01/01/a-rare-case-of-localized-pigmented-villonodular-synovitis-of-the-wrist-presenting-as-carpal-tunnel-syndrome/ |
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