Complementary Effects of Surgery and Pexidartinib in the Management of Patients with Complex Diffuse-Tenosynovial Giant Cell Tumor

Figure 10

Axial and sagittal images of a 55-year-old male with D-TGCT in the knee. (a) MRI with axial T2 fat suppressed images of the proximal lower leg. The large posteromedial hyperintense mass (star) shows a fluid-fluid level from the synovial fluid in the anterior aspect and proteinaceous and bloody fluid posteriorly. (b) MRI sagittal T1 view of the knee. Anteriorly, (star) the suprapatellar pouch is filled with an intermediate intensity fluid and contains diffuse hypointense material characteristic for the solid component of tenosynovial giant cell tumor. Posterior to the joint, there are multiple aggregations of hypointense masses along the posterior capsule and origins of the gastrocnemius muscles and the posterior cruciate ligament. Posteriorly, (arrow) the enormous popliteal cyst is evident with intermediate intensity. (c) MRI with sagittal T2 fat suppressed images of the knee. This shows the same fluid filled suprapatellar pouch with diffuse areas of lower intensity scattered throughout (star). Diffuse dark bands of thickened posterior capsule and tumor extend outside the joint and behind the posterior cruciate ligament (plus). The large hyperintense fluid filled popliteal cyst with scattered hypointense bands and nodules are present posteriorly (arrow).

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