Pigmented villonodular synovitis managed by Yttrium 90 after debulking surgery

Abstract

The goal of this study was to evaluate outcome of patients with pigmented villonodular synovitis (PVNS) managed by Yttrium90 (90Y) after debulking surgery. Seven patients (3 males and 4 females) with PVNS were studied retrospectively. Mean follow-up was 47.8 months (range 24-97 months). Mean age was 44.8 years (range 20-68 years. Debulking surgeries via arthroscopic synovectomy were performed in 4 cases and in 3 cases via mini arthrotomy. After 90Y injection was applied. Magnetic resonance imaging (MRI) included measurement of synovial thickness in preoperative and at last control. Main musculoskeletal tumor society score was 26 (range, 23-29), main MTS rating was 70.4% (range, 38.5-86.2%). Mean preoperative synovial thickness was 14.9mm range 20-12mm. Synovial thickness was completely disappeared at last MRI examination. There was diffuse joint effusion preoperatively, decreasing at last control. No cases of PVNS recurrence were found. Although we had a small number of cases, we believe that combination of debulking surgery with intra-articular injection of 90Y for PVNS of knee joint is an effective and safe treatment method.