Pigmented villonodular synovitis of the foot and ankle

Background: Pigmented villonodular synovitis (PVNS) is a rare disease of uncertain etiology usually affecting the synovium of weightbearing joints. Methods: We retrospectively evaluated 11 patients who were diagnosed and treated for PVNS of the ankle and foot over a 13-year period with a minimum of 2-year followup. Four patients with ankle joint PVNS and one patient with PVNS of the fifth metatarsophalangeal joint were seen initially at our institution and were treated with surgery alone. Six patients with ankle joint PVNS were referred to our institution for recurrent PVNS lesions; two of these patients were treated with excision alone, and the other four patients had surgical excision followed by radiation therapy with dosages ranging from 3600-4000 cGy. Results: No recurrence was noted at a mean followup of 9 years for primary lesions and 3.5 years for recurrent lesions. Conclusion: Based on these results, surgical excision of primary lesions and excision with postoperative radiation for recurrent lesions are recommended.