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Case Reports
. 2021 Feb 13;16(4):950-955.
doi: 10.1016/j.radcr.2021.01.064. eCollection 2021 Apr.

Tenosynovial giant cell tumor of the distal tibiofibular joint

Stephanie D Zarate  1 , David M Joyce  2 , Ana C Belzarena  1
Affiliations
Case Reports

Tenosynovial giant cell tumor of the distal tibiofibular joint

Stephanie D Zarate et al. Radiol Case Rep. .

Erratum in

Abstract

Tenosynovial giant cell tumors are extremely rare tumors with highly nonspecific symptoms. This benign but aggressive disease has a slow course of progression; however, it can ultimately lead to irreversible damage to a joint. Here we describe a case of a 45-year-old female with a diagnosis of tenosynovial giant cell tumors of the distal tibiofibular joint, the second case described in the literature for such location. Appropriate imaging studies and ultimately histologic studies are necessary for the correct diagnosis. Some locations are particularly unusual for these tumors making a high level of suspicion as well as treatment by an oncology orthopedic surgery specialist at a high-volume center paramount.

Keywords: Pigmented villonodular synovitis; Tenosynovial giant cell tumor; Tibiofibular joint.

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Figures

Fig 1
Fig. 1
Positron emission tomography with computed tomography. Axial images demonstrating uptake at the level of the distal tibiofibular joint (*) with a standard uptake value of 7.9 as well as scalloping of the distal lateral tibia (arrowhead).
Fig 2
Fig. 2
Magnetic resonance imaging study from August 2020 depicting the lesion in the distal tibiofibular joint (*), the distal lateral scalloping and posterior invasion into the soft tissues (arrowhead). (A) proton density sequency of 2 axial cuts view and 1 sagittal, (B) T1 fat suppressed with Gadolinium sequence, 2 axial cuts and 1 sagittal view, (C) short tau inversion recovery sequence, 2 axial cuts and 1 sagittal cut.
Fig 3
Fig. 3
Fluoroscopic images used for guidance during the biopsy mini-open procedure. A pituitary instrument is observed within the distal tibiofibular joint.
Fig 4
Fig. 4
Gross image of the sample obtained for pathology analysis during the biopsy. A mass with yellowish and brown areas is seen. (Color version of figure is available online.)
Fig 5
Fig. 5
Histopathological analysis of the left ankle mass resection. (A) low power view of the mass depicting sheets of cells of infiltrative nature and a dense stroma (H&E, 10x), (B) Dense small mononuclear cell stroma (H&E, 10x), (C) Mononuclear cell stroma and osteoclast-like multinucleated giant cells (H&E, 20x), (D) Giant cells in more detail, histocytes and foam cells (H&E, 20x).
See this image and copyright information in PMC

References

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