Definition
Benign tumour that arises from synovial tissues
- found near synovial-lined tendon sheaths
? Localised PVNS
Epidemiology
2nd most common tumour of the hand
Age 40 - 60
Aetiology
Unknown origin
- theorized to be localized form PVNS
- similar histology
- however, lacks the inflammatory component of PVS
- is considered by most to be a benign neoplasm
- may be a reactive process to minor trauma
Clinical
Usually found near flexor tendons of hands & feet
- painless, firm and multi-lobulated mass
- usually on volar surface of finger
May present with
- lump
- loss of function
X-ray
Can cause bone invasion and remodelling
MRI
Low signal on T1 and T2 and arising from the flexor sheath differentiates from sarcoma
Pathology
Gross
Arise from synovial tissue
1. Well-circumscribed & discrete
2. Nodular & encapsulated
Doesn't invade surrounding tissues
Diagnostic colour
- yellow (cholesterol)
- brown (haemosiderin)
- grey (fibrous tissue)
Histology
Giant cell tumours prominent
- hyalinised CT
- sheets of round, oval & spindle cells
- focal collections of foam cells - xanthoma cells
- scattered haemosiderin
Management
Marginal excision + bone currettage
Recurrence rate
- 10% - 20%
- to due to incomplete excision or spillage
- higher with bony involvement