Successful Treatment of Large Pigmented Villonodular Synovitis in the Ankle: Combined Surgery and Radiotherapy

Case Report

Volume 4, Issue 3

Successful Treatment of Large Pigmented Villonodular Synovitis in the Ankle: Combined Surgery and Radiotherapy

Ana Vilela^1*, Paulo Diogo Cunha¹, Diogo Gameiro², Marina Amorim³, José Miguel Rodrigues¹, Joana Azevedo¹, Joana Mesquita¹, Cláudia Vale¹, João Melo¹, Guilherme França¹, Pedro Varanda^1,4 and Marta Maio¹

¹Orthopaedics and Traumatology Department, Unidade Local de Saúde de Braga, Portugal
²Orthopaedics and Traumatology Department, Unidade Local de Saúde do baixo Mondego, Portugal
³Radiotherapy Department, Unidade Local de Saúde de Braga, Portugal
⁴Life and Health Science Research Institute, University of Minho, Portugal

^*Corresponding author: Ana Vilela, Orthopaedics and Traumatology Department, Unidade Local de Saúde de Braga, Portugal.
E-mail: anavilelaortopedia@gmail.com

Received: March 26, 2025; Accepted: April 10, 2025; Published: April 25, 2025

Citation: Vilela A, Cunha PD, Gameiro D, et al. Successful Treatment of Large Pigmented Villonodular Synovitis in the Ankle: Combined Surgery and Radiotherapy. Case Rep Orthop Surg J. 2025; 4(3): 148.

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Successful Treatment of Large Pigmented Villonodular Synovitis in the Ankle: Combined Surgery and Radiotherapy

Abstract

Pigmented Villonodular Synovitis (PVNS) is a rare, benign, but locally invasive tumor, affecting the ankle in less-than 10% of cases. MRI plays a key role in diagnosis, confirmed by pathology. Treatment is typically surgical excision; however, in large, diffuse cases, radiotherapy may help reduce recurrence. A 40-year-old male presented with left lateral malleolar tumefaction and ankle instability with recurrent sprains over two years. MRI confirmed diffuse PVNS. Surgical excision and adjuvant radiotherapy were performed without complications, leading to excellent functional recovery and a return to sports within 8 months. This case highlights the role of radiotherapy in managing large, diffuse PVNS, where surgery alone may be insufficient. Literature suggests adjuvant treatments improve the likelihood of complete resection. Combining surgery with radiotherapy enhances outcomes and lowers recurrence risk in extensive PVNS cases.

Keywords: Ankle tumor; Pigmented villonodular synovitis; Radiotherapy; Soft tissue mass; Surgical excision

Article Details

Successful Treatment of Large Pigmented Villonodular Synovitis in the Ankle: Combined Surgery and Radiotherapy