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Giant Cell Tumor of the Patella Tendon Sheath Presenting as a Painful Locked Knee

Andreas Panagopoulos, Pantelis Tsoumpos, Irini Tatani, Ilias Iliopoulos, Dionysios Papachristou

(Department of Sports Medicine, Orthopaedic Clinic, Patras University Hospital, Patras, Greece)

Am J Case Rep 2015; 16:568-573

DOI: 10.12659/AJCR.893849


BACKGROUND: The giant cell tumor of the tendon sheath (GCT-TS) is a benign proliferative synovial tumor manifesting as an intra-articular solitary nodule. When it involves the infrapatellar fat pad it can present acutely as a painful locked knee.
CASE REPORT: A 26-year-old white male presented with a 2-week history of painful locking in his right knee. Clinical examination revealed lack of extension by approximately 20°. To help establish the diagnosis, an MRI scan of the right knee was performed, showing a large (5×4×2 cm), oval, well-circumscribed mass with a low-intensity homogenous signal. The size of the mass prohibited the removal by arthroscopy and we therefore proceeded with an open arthrotomy. Histological examination showed a tendosynovial giant cell tumor of the patella tendon sheath. At the latest follow-up, 2 years postoperatively, there was no local tumor recurrence.
CONCLUSIONS: These rare tumorous lesions should be included in the differential diagnosis of painful locking knee, especially in the absence of definite traumatic history.

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