Radiation Oncology/Benign/PVNS

Pigmented Villonodular Synovitis Rare proliferative disorder affecting joints, tendons, and bursae Presnets as a nodule or a diffuse process of the synovium Typically monoarticular Young and middle-aged adults Not clear whether it is a chronic inflammatory process or a neoplastic process Work-up MRI, though presence of hemosiderin may overestimate size of lesion Primary treatment is surgical resection, although complete resection may be difficult to obtain Adjuvant therapy may include radioactive isotopes (Y90) or external beam RT For EBRT, University of Florida review recommends 35 Gy in 14-15 fractions Review University of Florida; 2006 17148989 -- "Pigmented villonodular synovitis." (Mendenhall WM, Am J Clin Oncol. 2006 Dec;29(6):548-50.)