PMC9826566_01
(a) T1 weighted axial MR image showing mildly hyperintense intra-articular mass-synovial hypertrophy in the left coxofemoral joint within tubular hypointense areas. (b and c) mass is well-circumscribed with lobulated contours, effusion in the joint and heterogeneous hypointense signal in axial and sagittal proton-density weighted images. (d) Pre-operative pelvis radiograph (e and f) Pathological evaluation revealed variable proportions of mononuclear cells, osteoclast-like giant cells, foamy histiocytes, and hemosiderin laden histiocytes (Hematoxylin and Eosin, x40, x200).
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F1
An magnetic resonance imaging (MRI) with IV contrast obtained after 24 h from first admission showed a 3 x 4 cm localized synovial nodule with mild heterogeneous synovial contrast enhancements and without bony invasion (Fig. 1a, b, c). Histomorphological findings were evaluated as intra-articular tenosynovial giant cell tumor-like proliferation, since it did not form a complete mass formation and was interpreted as reactive changes (Fig. 1d and e).
PMC9826566_02
(a) Widening and soft tissue thickening are observed in the coxofemoral joint in T1 weighted axial magnetic resonance image, but the borders of the mass are not clearly visualized. (b and c) proton density weighted axial and sagittal images showing mildly hyperintense mass with well borders in the anterior portion of the joint. (d) Pre-operative pelvis radiograph (e) Mononuclear stromal cells and osteoclast type giant cells in a collagenous background. (f) Multinuclear giant cells and hemosiderin pigments which are typical features for tenosynovial giant cell tumors (Hematoxylin and Eosin, x40, x200).
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F2
MRI was supposed to evaluate the hip for possible pelvic pathologies including metaphyseal or pelvic osteomyelitis. MRI obtained at the 5th h after submission revealed a localized synovial nodule without any bony invasion (Fig. 2a, b, c). Histomorphological evaluations revealed mononuclear stromal cells and osteoclast type giant cells in collagenous background, multinuclear giant cells, and hemosiderin pigments which are typical features for tenosynovial giant cell tumor (Fig. 2d and e) Last follow-up was at postoperative 17th months.
A 2 x 2, 5 x 1 cm red-brown, lobulated, and pedunculated mass excised from synovium
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F3
In addition, the lesion was dark brown macroscopically, as seen in necrotic tissues, and its pedicle was black, probably due to torsion or venous occlusion (Fig. 3).