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Spinal Pigmented Villonodular Synovitis: A Case Report

Gezen, Ferruh MD*; Akay, Kamil Melih MD*; Aksu, Aziz Yasar MD; Bedük, Altay MD*; Seber, Naci MD*

Case Report

Study Design This case report illustrates a young male patient with thoracal spinal pigmented villonodular synovitis who presented with difficulty in walking.

Objectives The treatment of this lesion with posterior approach for preventing neurological deterioration and follow-up with magnetic resonance imaging studies.

Summary of Background Data Spinal involvement of pigmented villonodular synovitis rare. It is treated by radical surgical excision. But in some cases, as in our case, surgical total excision of the lesion with a one-stage operation is not possible. For this reason, in such cases, follow-up studies with magnetic resonance images are sufficient. This report represents the 14th case of spinal involvement of pigmented villonodular synovitis.

Methods The patient presented with difficulty walking and received surgery including posterior decompression and subtotal tumor excision. All neurologic signs and symptoms disappeared in a short period. Postoperatively, follow-up studies with magnetic resonance imaging were performed and regrowth of residual lesion was not detected.

Results The patient was discharged home without neurologic deficit. Follow-up studies with magnetic resonance images showed no regrowth of residual lesion.

Conclusions The principle of surgical management of spinal lesions causing neurologic deficit is early surgical decompression. Although pigmented villonodular synovitis requires total excision, in the presented case total excision of lesion was impossible, because vertebral body involvement needs an anterior or posterolateral approach. During the 16-month follow up, regrowth of the lesion has not occurred. These observations indicate that surgical decompression and follow-up of a patient with magnetic resonance imaging constitute a satisfactory treatment of pigmented villonodular synovitis.

From the Departments of *Neurosurgery and Pathology, Gülhane Military Medical Academy, Ankara, Turkey.

Acknowledgment date: March 8, 1995.

First revision date: June 20, 1995.

Acceptance date: July 25, 1995.

Device status category: 1.

© Lippincott-Raven Publishers.