SPINAL PIGMENTED VILLONODULAR SYNOVITIS - A CASE-REPORT

Study Design. This case report illustrates a young male patient with t horacal spinal pigmented villonodular synovitis who presented with dif ficulty in walking. Objectives. The treatment of this lesion with post erior 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 tre ated by radical surgical excision. But in some cases, as in our case, surgical total excision of the lesion with a one-stage operation is no t possible. For this reason, in such cases, follow-up studies with mag netic resonance images are sufficient. This report represents the 14th case of spinal involvement of pigmented villonodular synovitis. Metho ds. The patient presented with difficulty walking and received surgery including posterior decompression and subtotal tumor excision. All ne urologic signs and symptoms disappeared in a short period. Postoperati vely, follow-up studies with magnetic resonance imaging were performed and regrowth of residual lesion was not detected. Results. The patien t was discharged home without neurologic deficit. Follow-up studies wi th magnetic resonance images showed no regrowth of residual lesion.Con clusions. The principle of surgical management of spinal lesions causi ng neurologic deficit is early surgical decompression. Although pigmen ted villonodular synovitis requires total excision, in the presented c ase total excision of lesion was impossible, because vertebral body in volvement needs an anterior or posterolateral approach. During the 16- month follow up, regrowth of the lesion has not occurred. These observ ations indicate that surgical decompression and follow-up of a patient with magnetic resonance imaging constitute a satisfactory treatment o f pigmented villonodular synovitis.