Abstract

Aim: Diffuse Tenosynovial Giant Cell Tumour (TGCT) formerly recognized under the synonym Pigmented Villonodular Synovitis (PVNS), is a proliferative, locally destructive, benign synovial tumour. Which most commonly affects monoarticular weight bearing joints. This disease often results in a debilitating functional impairment for the patient, early osteoarthritis, coupled with a tenacious recurrence rate. Current treatment options include early synovectomy, radiation therapy and colony stimulating factor-one (CSF-1) inhibitor Pexidartinib. However, there is a dearth of treatment protocols and management can prove difficult. The purpose of this study was to systematically review the most recent treatment methods of TGCT affecting weight bearing knee, hip, and ankle joints.

Methods: A systematic review of literature was carried out in July 2021. Keywords included “Treatment Options” and “Diffuse Tenosynovial Giant Cell Tumour.” The authors then examined 194 articles of which 36 articles were selected and read.

Study design: Review of Literature, level of evidence IV.

Results: 36 articles were selected.

Conclusion: It is apparent diffuse TGCT has the potential to cause severe functional impairment for the patient. A combination approach utilizing both surgical and systemic treatment modalities appear the current best clinical practice against this obdurate tumour.

Keywords: Diffuse tenosynovial giant cell tumour; Pigmented villonodular synovitis; Pexidartinib; Arthroscopic synovectomy; Open total synovectomy; Radiotherapy; CSF-1 inhibitors; Limb amputation