A rare presentation of pigmented villonodular synovitis.

Tenosynovial giant cell tumours are of two types, localised and diffuse. The diffuse type is also known as pigmented villonodular synovitis (PVNS). There have been 42 previously reported cases of PVNS in the axial skeleton, seven of which were reported in the thoracic spine. A young patient found to have thoracic PVNS and who presented with progressive lower limb weakness and parasthesiae over 3 weeks is reported. Computed tomography and magnetic resonance imaging demonstrated a posterior lesion at T6/7 with local bone invasion. The patient underwent complete resection of the tumour and has had an unremarkable postoperative convalescence with resolution of his signs and symptoms. Total surgical resection is the treatment of choice for this condition and close postoperative follow-up with serial imaging is important to monitor for local recurrence.