Abstract：
OBJECTIVE: A tenosynovial giant cell tumor (TGCT) is a proliferative lesion of the synovial membrane of the joints, tendon sheaths and/or bursae. There are two described subtypes, including the localized and diffuse forms. A TGCT can also be intraarticular or extraarticular. An intraarticular localized tenosynovial giant cell tumor (L-TGCT) of the knee is characterized by nodular hyperplasic synovial tissue that can remain asymptomatic for a long time, but as the mass grows, it may cause mechanical symptoms that may require surgical treatment. The aim of our study is to present a rare case of an L-TGCT of the knee joint treated with an arthroscopic excision.
METHODS: We describe the case of a 17-year-old female with pain, swelling and knee locking in the absence of trauma. The magnetic resonance imaging (MRI) displayed a well-circumscribed small mass in the anterior medial compartment, adherent to the infrapatellar fat pad. The lesion presented the typical MRI characteristics of an intraarticular localized TGCT. The patient was treated with an arthroscopic mass removal and partial synovectomy. The gross pathology showed an ovoid nodule that was covered by a fibrous capsule; a histopathology examination confirmed the diagnosis. The patient was able to return to normal daily activities one month after surgery; at the three-year follow-up, she was free of symptoms with no evidence of disease on the MRI.
CONCLUSIONS: In patients with a small-dimension L-TGCT in the anterior compartment of the knee that presents an MRI pattern and causes mechanical symptoms, an arthroscopic en-bloc excision can be performed that results in good outcomes and a rapid return to preinjury levels.
METHODS: We describe the case of a 17-year-old female with pain, swelling and knee locking in the absence of trauma. The magnetic resonance imaging (MRI) displayed a well-circumscribed small mass in the anterior medial compartment, adherent to the infrapatellar fat pad. The lesion presented the typical MRI characteristics of an intraarticular localized TGCT. The patient was treated with an arthroscopic mass removal and partial synovectomy. The gross pathology showed an ovoid nodule that was covered by a fibrous capsule; a histopathology examination confirmed the diagnosis. The patient was able to return to normal daily activities one month after surgery; at the three-year follow-up, she was free of symptoms with no evidence of disease on the MRI.
CONCLUSIONS: In patients with a small-dimension L-TGCT in the anterior compartment of the knee that presents an MRI pattern and causes mechanical symptoms, an arthroscopic en-bloc excision can be performed that results in good outcomes and a rapid return to preinjury levels.
摘要：
目的：腱鞘膜巨细胞瘤（TGCT）是关节滑膜的增生性病变，腱鞘和/或囊。有两个描述的亚型，包括局部和扩散形式。TGCT也可以是关节内或关节外。膝关节关节内局部腱膜巨细胞瘤（L-TGCT）的特征是结节性增生性滑膜组织，可以长时间无症状，但是随着质量的增长，它可能会导致机械症状，可能需要手术治疗。我们研究的目的是介绍一例罕见的膝关节L-TGCT经关节镜切除术治疗的病例。
方法：我们描述了一个17岁女性疼痛的案例，在没有外伤的情况下肿胀和膝盖锁定。磁共振成像（MRI）显示前内侧室有一个界限清楚的小肿块，粘附于髌下脂肪垫。病变呈现关节内局部TGCT的典型MRI特征。患者接受关节镜下肿块切除和部分滑膜切除术治疗。大体病理显示卵圆形结节被纤维囊覆盖；组织病理学检查证实了诊断。术后1个月患者恢复正常的日常活动;在3年的随访中,她没有症状，MRI没有疾病迹象。
结论：膝关节前室有小尺寸L-TGCT的患者表现为MRI模式并引起机械症状，可进行关节镜整块切除,结果良好,可迅速恢复至损伤前水平.
方法：我们描述了一个17岁女性疼痛的案例，在没有外伤的情况下肿胀和膝盖锁定。磁共振成像（MRI）显示前内侧室有一个界限清楚的小肿块，粘附于髌下脂肪垫。病变呈现关节内局部TGCT的典型MRI特征。患者接受关节镜下肿块切除和部分滑膜切除术治疗。大体病理显示卵圆形结节被纤维囊覆盖；组织病理学检查证实了诊断。术后1个月患者恢复正常的日常活动;在3年的随访中,她没有症状，MRI没有疾病迹象。
结论：膝关节前室有小尺寸L-TGCT的患者表现为MRI模式并引起机械症状，可进行关节镜整块切除,结果良好,可迅速恢复至损伤前水平.
