Radiation Oncology Journal

The Korean Society for Radiation Oncology (대한방사선종양학회)
권호 표지

Combined Arthroscopic Gross Total Synovectomy and Radiotherapy for Diffuse Pigmented Villonodular Synovitis of the Knee: A Report of 2 Cases

무릎관절의 미만형 색소 융모 결절성 활액막염에서 관절경을 이용한 육안적 활액막 전 절제술 후 방사선치료: 증례보고

  • Chang, Sei-Kyung (Department of Radiation Oncology, Bundang CHA General Hospital, Pochon CHA University) ;
  • Kim, Jae-Hwa (Department of Orthopedic Surgery, Bundang CHA General Hospital, Pochon CHA University) ;
  • Ha, Doo-Hoe (Department of Radiology, Bundang CHA General Hospital, Pochon CHA University) ;
  • Kang, Hae-Youn (Department of Pathology, Bundang CHA General Hospital, Pochon CHA University) ;
  • Chong, So-Young (Department of Internal Medicine, Bundang CHA General Hospital, Pochon CHA University) ;
  • Shin, Hyun-Soo (Department of Radiation Oncology, Bundang CHA General Hospital, Pochon CHA University)
  • 장세경 (포천중문의과대학교 분당차병원 방사선종양학과) ;
  • 김재화 (포천중문의과대학교 분당차병원 정형외과) ;
  • 하두회 (포천중문의과대학교 분당차병원 진단방사선과) ;
  • 강혜운 (포천중문의과대학교 분당차병원 병리과) ;
  • 정소영 (포천중문의과대학교 분당차병원 내과) ;
  • 신현수 (포천중문의과대학교 분당차병원 방사선종양학과)
  • Published : 2006.09.30
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Abstract

Pigmented villonodular synovitis (PVNS) is a rare proliferative disease involving synovial membranes. Natural history and etiology of PVNS are not well known. PVNS presents as localized or diffuse tumor like nodular lesion of the synovial lining of the joint and the synovial spaces adjacent to the joints. Though histologically benign, it is a very aggressive lesion, capable of bone destruction and widespread infiltration of surrounding tissues. Standard therapy is surgical resection, but due to the infiltrative growth, the recurrence rate is significantly high. After several relapses surgical treatment of diffuse PVNS becomes difficult and may require amputation of the involved limb. Radiotherapy can provide an effective treatment option for patients with large lesions or lesions which are not suitable for surgery, after incomplete resection to prevent relapses or to avoid amputation. We report 2 cases of diffuse PVNS in the knee joint treated with arthroscopic gross total synovectomy and radiotherapy.

색소 융모 결절성 활액막염(pigmented villonodular synovitis, PVNS)은 병인이 밝혀지지 않은 증식성 질환으로, 병변의 범위에 따라 국소형과 미만형으로 분류되며, 조직학적으로 양성이지만 파괴적인 성향을 보이므로 연골의 파괴나 주위 조직으로 광범위한 침윤이 가능한 질환이다. 활액막 절제술이 일차적인 치료방법이지만 미만형인 경우에는 주위 조직을 침윤하는 성향 때문에 재발률이 높다. 재발이 반복된 후에는 수술적 절제가 어려워져서 병변부위의 절단이 필요하게 되므로, 광범위한 병변인 경우, 수술이 용이하지 않은 경우, 또는 불완전 절제가 시행된 경우 등에서 방사선치료를 시행하여 재발을 방지할 수 있다고 보고되고 있다. 저자들은 무릎관절의 미만형 색소 융모 결절성 활액막염으로 관절경을 이용한 육안적 활액막 전 절제술 후 방사선치료를 시행한 2예를 경험하였기에 문헌고찰과 함께 보고하고자 한다.

Keywords

References

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