Chronic hemorrhagic villous synovitis of the spine

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Abstract

Case of chronic hemorrhagic villous synovitis (CHVS) of the spine in 20-years old male is presented. Tumorlike formation was located in lumbar region. The initial diagnosis was the benign tumor which was removed. Two years postoperatively the recurrence with light neurologic deficit was detected. MRT revealed multi- nodulous formation with homogenous structure and 11.8 x 8.7 cm in size. The formation spread rightly, posteriorly and infiltrated into soft tissues and iliac bone. Biopsy results suspected malignant «histiocytoma» and symptomatic treatment was recommended. In specialized hospital repeated biopsy was and CHVS was diagnosed. Pathologic focus was removed and destroyed L3 spinous process and lateral sacrum were resected. Postoperatively radiotherapy (60 Gy) was given. Seven months after surgery no recurrence was detected. Diagnostic problems are discussed. In CHVS authors recommend to use the combined treatment.

About the authors

A. N. Makhson

Moscow City Clinical Oncology Hospital No. 62

Author for correspondence.
Email: info@eco-vector.com
Russian Federation, Moscow

I. V. Kuzmin

Moscow City Clinical Oncology Hospital No. 62

Email: info@eco-vector.com
Russian Federation, Moscow

Y. V. Maksimchuk

Moscow City Clinical Oncology Hospital No. 62

Email: info@eco-vector.com
Russian Federation, Moscow

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Supplementary files

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2. Fig. 1. Magnetic resonance imaging of patient B. in sagittal (a) and axial (b) projections; slice thickness 4 and 5 mm.

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3. Fig. 2. Microphotograms of the lesion of the soft tissues of the lumbar region of patient B. Pigmented villezonodular synovitis of the spine. a - characteristic slit-like spaces lined with cells resembling synoviocytes. In one of the gaps there is a multinucleated giant cell; b — accumulation of xanthoma cells and grains of hemosiderin in the immediate vicinity of the slit-like space. Stained with hematoxylin and eosin. SW. 200.

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