Tenosynovial giant cell tumor

Tenosynovial giant cell tumor
Other namesLocalized: Localized pigmented villonodular synovitis (L-PVNS), Giant cell tumor of the tendon sheath (GCT-TS), Nodular tenosynovitis, Localized nodular tenosynovitis, and L-TGCT
Diffuse: Pigmented villonodular synovitis (PVNS), Conventional PVNS, and D-TGCT
Micrograph of diffuse TGCT, also known as pigmented villonodular synovitis. H&E stain.
SpecialtyOncology
SymptomsSwelling, pain, stiffness, sensitivity, and/or limited range of motion
ComplicationsOsteoarthritis
Usual onsetMost patients are diagnosed between the age of 30-50.
TypesDiffuse and localized
Diagnostic methodMRI, biopsy, surgery
Differential diagnosisFibromas, Baker’s cyst, tophaceous gout, synovial sarcoma, hemangioma, synovial chondromatosis, hemorrhagic synovitis
TreatmentSurgery, CSF1R inhibitors
MedicationImatinib, Pexidartinib, Vimseltinib

Tenosynovial giant cell tumor (TGCT) is a non-malignant tumor defined histologically as inclusions of “osteoclast-like” multinucleated giant cells, hemosiderin, and macrophages. This histology can present one of 2 clinically distinct ways. Localized/nodular TGCT (L-TGCT), sometimes referred to as “giant cell tumor of the tendon sheath”;:100 is a common tumor that presents as a slow-growing, encapsulated, localized and limited bump, most frequently in the fingers. Diffuse TGCT (D-TGCT) — also called pigmented villonodular synovitis (PVNS)— is a rare tumor that presents as a proliferative, destructive, intra-articular lesion, most commonly in the knee.:102 D-TGCT tumors often develop from the lining of joints (also known as synovial tissue).:100:245. Common symptoms of D-TGCT include swelling, pain, stiffness and reduced mobility in the affected joint or limb.:102