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Miller RLR, Donaldson EK, Giuffre JL. Synovial Lipomatosis With Extra-articular Extension in the Arthritic Wrist: An Unexpected Diagnosis. Ann Plast Surg 2024; 92:528-532. [PMID: 38685493 DOI: 10.1097/sap.0000000000003937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/02/2024]
Abstract
ABSTRACT Synovial lipomatosis is a rare condition characterized by adipocyte proliferation within joint synovial tissue. It most commonly affects the knee and is typically intra-articular. Only 5 published case reports describe extra-articular synovial lipomatosis of the wrist. We present a case of a sexagenarian patient seen for his wrist arthropathy. His x-ray revealed pan-wrist arthritis and inflammatory soft tissue swelling. The patient was slated for a wrist fusion and Darrach procedure. Following the dorsal skin incision in the operating room, an unusual adipose mass was identified infiltrating all extensor compartments: midcarpal, radiocarpal, and distal radioulnar joints. The mass was excised and sent to pathology prior to proceeding with the slated surgery. Synovial lipomatosis was diagnosed postoperatively based on histopathology. Six weeks postoperatively, the wrist fusion had healed clinically and radiographically, and his pain had improved. There was no evidence of recurrence. Synovial lipomatosis is a rare entity that may imitate multiple other pathologies. It is possible that synovial lipomatosis may represent a secondary occurrence following degenerative articular disease or trauma in older patients. This is the first case report to date describing synovial lipomatosis of the wrist with extra-articular extension in the setting of pan-carpal wrist arthritis.
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Affiliation(s)
- Rebecca L R Miller
- From the Section of Plastic Surgery, Department of Surgery, University of Manitoba, Winnipeg, Manitoba, Canada
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Elafram R, Ben Romdhane M, Khessairi N, Hamdi A. Case Report: Synchronous bilateral lipoma arborescens of the bicipitoradial bursa. F1000Res 2022; 11:787. [PMID: 38433998 PMCID: PMC10907874 DOI: 10.12688/f1000research.122432.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/30/2022] [Indexed: 03/05/2024] Open
Abstract
Background: Lipoma arborescens (LA) is an infrequent benign tumor made of mature sub-synovial fatty cell proliferation that may arise into the synovial joint, the bursae or the tendon sheaths. This condition affects mainly the knee joint, but the bicipitoradial bursa is an exceptional location. We report herein a case of a synchronous bilateral (LA) of the bicipitoradial bursa. Case presentation: A 52-year-old patient, with no medical history, presented with a swelling of both front arms that had been progressing for nine years. Physical examination showed a mass in the antecubital fossae of 3cm on the left side and 0.5cm on the right side. Both masses were tender, well-defined, fixed, without inflammatory signs and painful on elbow flexion. A magnetic resonance imaging (MRI) scan was performed, revealing the presence of a septate soft-tissue mass of the distal portion of the brachial muscle of 70x46x27mm. This mass had a heterogeneous fat signal in its depth and a homogeneous fat composition on the outside. The diagnosis of liposarcoma was suspected. The patient underwent surgery to remove both masses. Gross examination showed a characteristic frond-like or digitiform pattern. Microscopical examination demonstrated papillary proliferation of the synovial villi. The final diagnosis was of LA. The patient had no complications and there was no recurrence of LA. Conclusions: LA is a rare condition, and the bicipitoradial bursa is an exceptional location. Histological confirmation is mandatory to correct the diagnosis.
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Affiliation(s)
- Rafik Elafram
- Homeland Security Forces Hospital, Tunis Elmanar University, La Marsa, 2074, Tunisia
| | - Majdi Ben Romdhane
- Homeland Security Forces Hospital, Tunis Elmanar University, La Marsa, 2074, Tunisia
| | - Nayssem Khessairi
- Homeland Security Forces Hospital, Tunis Elmanar University, La Marsa, 2074, Tunisia
| | - Ahmed Hamdi
- Homeland Security Forces Hospital, Tunis Elmanar University, La Marsa, 2074, Tunisia
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Kostas-Agnantis I, Gkiatas I, Korompilia M, Kosmas D, Motsis E, Pakos E, Korompilias A. Lipoma Arborescens of the Upper Extremity With Anatomic Variation of the Palmaris Longus: A Case Report. JBJS Case Connect 2022; 12:01709767-202209000-00045. [PMID: 36099386 DOI: 10.2106/jbjs.cc.22.00334] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Accepted: 07/20/2022] [Indexed: 06/15/2023]
Abstract
CASE We present a case of a patient who suffered from wrist swelling and had symptoms of carpal tunnel syndrome. The patient underwent ultrasound and magnetic resonance imaging, in which signs of joint effusion and a fatty synovial lesion were presented. The treatment included open excision of the tumor. In addition, the palmaris longus muscle had an anatomic variation with proximal and distal tendon portions. The histopathological examination disclosed lipoma arborescens of the synovial membranes of the joints. CONCLUSION The recognition of this entity and its characteristics are important not only for correct diagnosis but also for the appropriate treatment.
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Affiliation(s)
- Ioannis Kostas-Agnantis
- Department of Orthopaedic Surgery, University of Ioannina School of Medicine, Ioannina, Greece
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Kalifis G, Maffulli N, Migliorini F, Marín Fermín T, Hovsepian JM, Stefanou N, Hantes M. Surgical management of upper limb lipoma arborescens: a systematic review. J Orthop Surg Res 2022; 17:138. [PMID: 35246183 PMCID: PMC8896089 DOI: 10.1186/s13018-022-02997-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Accepted: 02/04/2022] [Indexed: 11/16/2022] Open
Abstract
Background Lipoma arborescens (LA) is a rare benign synovial tumour characterized by the proliferation of mature adipocytes within the synovial cells. Given its rarity, current evidence is mainly based on case reports and case series, and no guidelines are available. The present study investigated the current surgical management and related outcomes of LA in the upper limb. Methods This systematic review was conducted following the PRISMA guidelines. PubMed, Scopus, and Virtual Health Library were accessed in September 2021. Clinical studies evaluating patients with LA undergoing surgical treatment were considered eligible for this systematic review. Only studies which reported data on LA located in the upper limb with histopathological confirmation were considered. Articles that reported data from nonsurgical management were not considered. Results A total of 21 studies reporting 22 lesions in 21 patients were assessed. The mean age of the patients was 48.48 years (range 22–77). Most studies evaluated the restoration of range of motion and symptom resolution for the functional outcome assessment. Open or arthroscopic excision and synovectomy were the most common surgical procedures for LA. The concomitant lesions were treated in a single-stage procedure. All patients had satisfactory outcomes after open or arthroscopic excision and synovectomy without recurrence at a mean follow-up of 21.14 months (range 2–60). One patient developed postoperative cellulitis (4.55%). Conclusion Open and arthroscopic excision combined with synovectomy should be considered the standard treatment option of upper limb LA. Concomitant pathologies can be addressed in a one-stage procedure. Although LA was recognized as a clinical entity decades ago, there is a lack of evidence based guidelines and long term outcome data are unavailable.
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Affiliation(s)
- Georgios Kalifis
- Department of Trauma and Orthopaedics, Hull Royal Infirmary, Anlaby Road, Hull, UK.,Department of Trauma and Orthopaedic Surgery, University Hospital of Larissa, Larissa, Greece
| | - Nicola Maffulli
- Department of Medicine, Surgery and Dentistry, University of Salerno, Baronissi, Italy.,School of Pharmacy and Bioengineering, Keele University School of Medicine, Stoke on Trent, England.,Barts and the London School of Medicine and Dentistry, Centre for Sports and Exercise Medicine, Queen Mary University of London, Mile End Hospital, London, England
| | - Filippo Migliorini
- Department of Orthopaedic, Trauma, and Reconstructive Surgery, RWTH Aachen University Hospital, Pauwelsstr. 30, 52074, Aachen, Germany.
| | | | | | - Nikolaos Stefanou
- Department of Trauma and Orthopaedic Surgery, University Hospital of Larissa, Larissa, Greece
| | - Michael Hantes
- Department of Trauma and Orthopaedic Surgery, University Hospital of Larissa, Larissa, Greece
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Baidoo PK, Nketiah‐Boakye F, Tano EK, Al‐Hassan M, Yorke GOM, Awoonor‐Williams R, Boakye E. Lipoma arborescens in a 16-year-old male: A case report. Clin Case Rep 2021; 9:e05230. [PMID: 34976396 PMCID: PMC8684577 DOI: 10.1002/ccr3.5230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2021] [Revised: 12/06/2021] [Accepted: 12/07/2021] [Indexed: 11/10/2022] Open
Abstract
Lipoma arborescens is a benign intra-articular tumor characterized by joint effusions, pain, and reduced range of motion. It is rare in adults and children. We present a case of lipoma arborescens in a 16-year-old male. The work up involved plain radiographs, MRI, incisional biopsy, and laboratory analysis.
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Affiliation(s)
- Paa Kwesi Baidoo
- Directorate of Orthopedics and TraumaKomfo Anokye Teaching HospitalKumasiGhana
| | | | | | | | | | | | - Ernest Boakye
- Department of PathologyKomfo Anokye Teaching HospitalKumasiGhana
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Orekhova A, Schwarz T. Synovial lipomatosis of the stifle joint in a dog. VETERINARY RECORD CASE REPORTS 2021. [DOI: 10.1002/vrc2.163] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Anna Orekhova
- Moscow private veterinary clinic “Beliy Klyk” Moscow Russia
| | - Tobias Schwarz
- Clinical Veterinary Studies Easter Bush Veterinary Centre The University of Edinburgh Roslin UK
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Abstract
INTRODUCTION Lipoma Arborescens is a rare pathology that mainly affects the knee. Occurrences in the elbow are even more uncommon and mainly involve the bicipitoradial bursa. CASE'S DESCRIPTION We describe the case of a 54-year-old patient known for rheumatoid arthritis, who consulted for chronic elbow pain associated with swelling and limited extension. DIAGNOSIS The diagnosis of a lipoma arborescens of the elbow involving the whole joint was made using magnetic resonance imaging and confirmed during arthroscopy. INTERVENTIONS After a failed nonoperative treatment consisting in intra-articular cortisone injections and physiotherapy, the patient underwent arthroscopic synovectomy and arthrolysis. OUTCOME At 1-year follow-up, he reported no pain, satisfactory range of motion, and major improvements in clinical scores. CONCLUSION This is the first illustrated case report about lipoma arborescens involving the whole elbow joint. Even though it is a rare disease, awareness of its presentation, imaging patterns, and treatment options is therefore important for clinicians, radiologists, and surgeons. In this case, arthroscopic treatment resulted in satisfactory and long-lasting pain relief and functional results. It may be considered as a safe and effective option in case of failed nonoperative measures.
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Affiliation(s)
| | - Gregory Cunningham
- Department of Orthopaedics and Trauma Surgery, Geneva University Hospitals, Switzerland, Rue Gabrielle-Perret-Gentil 4
- Shoulder Center, Hirslanden Clinique la Colline, Geneva, Switzerland
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Cerqueira WS, Melo RABD, Costa FD, Comunello J, Bitencourt AGV, Chung WT. Lipoma arborescens do cotovelo: um caso com características de tumor de alto grau. Rev Bras Ortop 2018. [DOI: 10.1016/j.rbo.2017.03.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022] Open
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Cerqueira WS, Melo RABD, Costa FD, Comunello J, Bitencourt AGV, Chung WT. Lipoma arborescens of the elbow: a case with features of a high-grade tumor. Rev Bras Ortop 2017; 53:252-256. [PMID: 29911095 PMCID: PMC6001356 DOI: 10.1016/j.rboe.2017.03.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2016] [Accepted: 03/03/2017] [Indexed: 11/03/2022] Open
Abstract
Lipoma arborescens (LA) is an uncommon non-neoplastic disorder that may affect almost any joint, mainly the knee. LA is very rare in the elbow, and there are only a few cases reported in the literature. This study aimed to describe a case of LA in the elbow, presenting with features of a high-grade tumor. The authors report the case of a 51-years-old male who presented to this institution with pain and swelling on the left elbow. The patient had a seven-year history of investigation, with inconclusive diagnosis. Magnetic resonance imaging (MRI) showed an expansive mass with local aggressiveness. Due to these characteristics, it was not possible to discard soft tissue sarcoma at the differential diagnosis. After biopsy and a multidisciplinary team meeting, the authors opted for surgical resection. The final anatomopathological result confirmed the diagnosis of LA. Despite not being a true neoplasm, LA can cause many symptoms and functional impairment of the affected joint. It is important to keep this diagnosis in mind when any expansive mass surrounding a joint is observed.
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Affiliation(s)
| | | | | | | | | | - Wu Tu Chung
- A. C. Camargo Cancer Center, São Paulo, SP, Brazil
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Synovial Lipomatosis of the Glenohumeral Joint. Case Rep Orthop 2016; 2016:4170923. [PMID: 27563476 PMCID: PMC4983660 DOI: 10.1155/2016/4170923] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2016] [Accepted: 06/29/2016] [Indexed: 11/21/2022] Open
Abstract
Synovial lipomatosis (also known as lipoma arborescens) is a rare and benign lesion affecting synovium-lined cavities. It is characterized by hyperplasia of mature fat tissue in the subsynovial layer. Although the most commonly affected site is the knee joint, rarely additional locations such as tendon sheath and other joints are involved. We present a case of synovial lipomatosis of the glenohumeral joint in a 44-year-old man. The clinical data radiological studies and histopathologic results are described, as well as a review of the current literature.
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Minami S, Miyake Y, Kinoshita H. Lipoma arborescens arising in the extra-articular bursa of the knee joint. SICOT J 2016; 2:28. [PMID: 27382924 PMCID: PMC4935798 DOI: 10.1051/sicotj/2016019] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2015] [Accepted: 05/15/2016] [Indexed: 11/14/2022] Open
Abstract
Lipoma arborescens arising in the extra-articular bursa of the knee joint is extremely rare. We describe an 11-year-old boy who complained of a gradual swelling mass of the lateral knee joint. Magnetic resonance imaging (MRI) showed a high signal intensity tumor on T1- and T2-weighted images with a thickened septa and nodular lesion that showed low signal intensity. The radiologist suggested the possible differential diagnosis of well-differentiated liposarcoma. At operation, the tumor was found under the iliotibial tract and was not in contact with the knee joint. Histopathologically, this lesion was diagnosed as lipoma arborescens arising in the extra-articular bursa of the knee joint. On MRI, the appearance of lipoma arborescens arising in the extra-articular bursa of the knee joint differed from that of conventional intra-articular lipoma arborescens. In this report, we describe a case of extra-articular lipoma arborescens of the knee joint bursa and discuss the diagnosis and etiology.
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Affiliation(s)
- Shinji Minami
- Department of Orthopedic Surgery, Naga Municipal Hospital, 1282 Uchita, Kinokawa, Wakayama 649-6414, Japan
| | - Yusuke Miyake
- Department of Orthopedic Surgery, Wakayama Medical University, 811-1 Kimiidera, Wakayama 641-8510, Japan
| | - Hirofumi Kinoshita
- Department of Orthopedic Surgery, Naga Municipal Hospital, 1282 Uchita, Kinokawa, Wakayama 649-6414, Japan
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Lipoma Arborescens: Review of an Uncommon Cause for Swelling of the Knee. Case Rep Orthop 2016; 2016:9538075. [PMID: 27293937 PMCID: PMC4884798 DOI: 10.1155/2016/9538075] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2016] [Accepted: 05/04/2016] [Indexed: 11/22/2022] Open
Abstract
Lipoma arborescens is a rare cause of chronic monoarticular arthritis, with only a few cases reported in the literature. It is most commonly seen in the knee, but cases in other joints such as the wrist, shoulder, and elbow have also been described. It is a benign condition, in which the subsynovial tissue is replaced diffusely by mature fat cells. We describe a case involving the knee and discuss the symptoms, diagnosis, and treatment.
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Kamran F, Kavin K, Vijay S, Shivanand G. Bilateral lipoma arborescens with osteoarthritis knee: Case report and literature review. J Clin Orthop Trauma 2015; 6:131-6. [PMID: 25983521 PMCID: PMC4411376 DOI: 10.1016/j.jcot.2014.12.006] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2014] [Accepted: 12/13/2014] [Indexed: 10/24/2022] Open
Abstract
Lipoma arborescens is villous proliferation of synovium and is often unilateral in the absence of any systemic disease. We report a case of 54 year old male presenting with bilateral lipoma arborescens associated with osteoarthritis. The diagnosis is often difficult due to similar symptomatology of lipoma arborescens and osteoarthritis.
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Affiliation(s)
- Farooque Kamran
- Additional Professor, Department of Orthopaedics, All India Institute of Medical Sciences, New Delhi, India
| | - Khatri Kavin
- Senior Resident, Department of Orthopaedics, All India Institute of Medical Sciences, New Delhi, India,Corresponding author. Room No 311, Doctor's Hostel, JPNATC-AIIMS, Safdarjung Enclave, New Delhi, India. Tel.: +91 (0) 8743878077.
| | - Sharma Vijay
- Additional Professor, Department of Orthopaedics, All India Institute of Medical Sciences, New Delhi, India
| | - Gamangatti Shivanand
- Additional Professor, Department of Radio Diagnosis, All India Institute of Medical Sciences, New Delhi, India
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Klein DR. Lipoma arborescens of the knee: a case report. REVISTA BRASILEIRA DE ORTOPEDIA (ENGLISH EDITION) 2014; 49:74-7. [PMID: 26229776 PMCID: PMC4511697 DOI: 10.1016/j.rboe.2014.01.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/02/2012] [Accepted: 03/22/2013] [Indexed: 11/19/2022]
Abstract
Case report of a female patient of 26 years who complained of pain and recurrent episodes of joint swelling in his left knee about 10 years ago. After anamnesis, physical examination and radiographic imaging and magnetic resonance were diagnosed with arborescent lipoma of the knee, and the patient underwent arthroscopic treatment for resection of the lesion. Postoperatively the patient was referred to physical therapy rehabilitation with good evolution.
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Howe B, Wenger D. Lipoma arborescens: Comparison of typical and atypical disease presentations. Clin Radiol 2013; 68:1220-6. [DOI: 10.1016/j.crad.2013.07.002] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2013] [Revised: 06/15/2013] [Accepted: 07/01/2013] [Indexed: 12/28/2022]
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Progressive bilateral lipoma arborescens of the knee complicated by juvenile spondyloarthropathy: A case report and review of the literature. Semin Arthritis Rheum 2013; 43:259-63. [DOI: 10.1016/j.semarthrit.2012.12.022] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2012] [Revised: 11/30/2012] [Accepted: 12/07/2012] [Indexed: 11/21/2022]
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Abstract
Lipoma arborescens, a rare benign intra-articular lesion, is characterized by lipomatous proliferation of the synovium in which the subsynovial tissue is replaced by mature adipocytes. Subdeltoid bursa is a rare location for lipoma arborescens, and only a few cases have been reported in the literature. This article reports 2 cases of subdeltoid lipoma arborescens combined with rotator cuff tears, and the possible relationships between subdeltoid lipoma arborescens and rotator cuff tears are discussed. The intra-articular villous proliferations on fat-suppressed T2-weighted magnetic resonance imaging appeared as yellowish-white lipomatous villous proliferations on arthroscopy, and finger-like lipomatous proliferation of the synovium, where the subsynovial connective tissue is replaced by mature adipocytes, on histology. Although further evidence would be necessary, the bony proliferations, in addition to bone-to-bone abrasion and inflammatory processes, may contribute to the relationship between subdeltoid lipoma arborescens and rotator cuff tears. Because this is a rare disease in a rare location, no established treatment guidelines are available for lipoma arborescens in subdeltoid bursa. For the current patients, arthroscopic excision of the lipoma arborescens and concomitant rotator cuff repair were prescribed after more than 6 months of conservative management. All patients had symptom relief and were satisfied with their results. Paying special attention to the radiologic and arthroscopic characteristics of the lipoma arborescens will help physicians and surgeons to achieve a more accurate diagnosis and effective treatment strategy, especially in patients with concomitant rotator cuff tears.
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Abstract
We report a patient with a lipoma arborescens in the knee, a chance finding discovered on MRI. This is an unusual cause of swelling of the knee joint; if this condition is present, it is almost always located in the suprapatellar pouch. In this case, the lipoma arborescens was found in the popliteal space.
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Al-Qattan MM, Al-Lazzam AM, Al Thunayan A, Al Namlah A, Mahmoud S, Hashem F, Tulbah A. CLASSIFICATION OF BENIGN FATTY TUMOURS OF THE UPPER LIMB. ACTA ACUST UNITED AC 2012; 10:43-59. [PMID: 16106500 DOI: 10.1142/s0218810405002541] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2004] [Accepted: 06/09/2005] [Indexed: 11/18/2022]
Abstract
In this paper, the authors offer a classification of benign fatty tumours of the upper limb. There are three histologically distinct types of fat cells: immature fat cells which give rise to lipoblastomas, mature brown fat cells which give rise to hibernomas and mature white fat cells which give rise to lipomas. Lipomas are the most common and they are sub-classified according to the anatomic site of fat cells into dermal, subcutaneous and sub-fascial lipomas; or tumours directly related to muscle, bone, synovium or nerve. Finally, the authors review 67 patients with benign fatty tumours of the upper limb and provide clinical examples of these tumours including their characteristic histological and radiological features.
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Affiliation(s)
- M M Al-Qattan
- Division of Plastic Surgery, King Saud University, King Fahad National Guard Hospital, Riyadh, Saudi Arabia.
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Le Corroller T, Gaubert JY, Champsaur P, Gravier R, Airaudi S, Argenson JN. Lipoma arborescens in the bicipitoradial bursa of the elbow: sonographic findings. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2011; 30:116-118. [PMID: 21193713 DOI: 10.7863/jum.2011.30.1.116] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
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Moukaddam H, Smitaman E, Haims AH. Lipoma arborescens of the peroneal tendon sheath. J Magn Reson Imaging 2010; 33:221-4. [DOI: 10.1002/jmri.22352] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
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A case of intra-articular synovial lipoma of the knee joint causing patellar dislocation. Knee Surg Sports Traumatol Arthrosc 2010; 18:1094-7. [PMID: 19997720 DOI: 10.1007/s00167-009-1005-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2009] [Accepted: 11/17/2009] [Indexed: 10/20/2022]
Abstract
Intra-articular synovial lipoma is rare and clinically manifested mostly by mass effect and occasionally by torsion of the stalk. Patellar dislocation rarely occurs owing to a mass effect of intra-articular tumor of the knee joint. The authors present a case of large intra-articular synovial lipoma at the lateral gutter of the knee joint, which presents as patellar dislocation. A 19-year-old man visited our clinic due to pain and limitation of motion owing to mass at his left knee. MRI revealed an intra-articular soft tissue mass at the lateral gutter of the knee joint with considerable mass effect displacing patella from the trochlear groove. Excisional biopsy confirmed the diagnosis of lipoma, and the final diagnosis was intra-articular synovial lipoma with clinical information. The final radiograph showed well-aligned patella on the trochlear groove. After marginal excision, there was no recurrence or tumor-related morbidity.
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Chae EY, Chung HW, Shin MJ, Lee SH. Lipoma arborescens of the glenohumeral joint causing bone erosion: MRI features with gadolinium enhancement. Skeletal Radiol 2009; 38:815-8. [PMID: 19290523 DOI: 10.1007/s00256-009-0686-x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2008] [Revised: 03/02/2009] [Accepted: 03/04/2009] [Indexed: 02/02/2023]
Abstract
Lipoma arborescens is a rare benign intra-articular lesion that principally affects the knee joint. We present a case of lipoma arborescens involving the glenohumeral joint and associated with prominent large bony erosions. The gadolinium diethylenetriamine pentaacetic acid-enhanced magnetic resonance imaging (MRI) features of this lesion are also described. The characteristic MRI findings permit precise preoperative diagnosis of this rare condition even if it occurs in an atypical location and there are confusing radiological findings.
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Affiliation(s)
- Eun Young Chae
- Department of Radiology, University of Ulsan College of Medicine, Asan Medical Center, 86, Asanbyeongwon-gil, Songpa-gu, Seoul, 138-736, South Korea
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Dogramaci Y, Kalaci A, Sevinç TT, Atik E, Esen E, Yanat AN. Lipoma arborescens of the peroneus longus and peroneus brevis tendon sheath: case report. J Am Podiatr Med Assoc 2009; 99:153-6. [PMID: 19299354 DOI: 10.7547/0980153] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Lipoma arborescens is an uncommon pseudotumoral synovial lesion usually located in the suprapatellar pouch of the knee. Lipoma arborescens involving the synovial sheaths of the tendons is exceedingly rare. This diagnosis should be considered, particularly in patients with chronic joint effusion. We report a case with lipoma arborescens affecting the synovial sheaths of the peroneal tendons without involvement of the adjacent ankle joint. To our knowledge, this is the second reported case of lipoma arborescens involving tenosynovial sheaths of tendons around the ankle joint without ankle joint involvment.
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Affiliation(s)
- Yunus Dogramaci
- Department of Orthopaedics and Traumatology, Mustafa Kemal University, Tayfur Atasokmen tip Fakultesi, Antakya, Hatay, Turkey.
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Mayayo Sinués E, Soriano Guillén AP, Azúa Romeo J, Canales Cortés V. [Lipoma arborescens of the bicipital bursa]. REUMATOLOGIA CLINICA 2009; 5:128-30. [PMID: 21794594 DOI: 10.1016/j.reuma.2008.11.010] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/18/2008] [Accepted: 11/28/2008] [Indexed: 10/21/2022]
Abstract
Lipoma arborescens is a rare benign entity characterized by proliferation of villous fat tissue in subsynovial layer that usually affects the knee joint. We report a case of lipoma arborescens in bicipitoradial bursa of the elbow in a 44 year-old female patient. In spite of this rare location, radiographic findings by ultrasonography and magnetic resonance imaging made diagnosis possible.
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Affiliation(s)
- Esteban Mayayo Sinués
- Servicio de Radiodiagnóstico, Hospital Universitario Miguel Servet, Zaragoza, España
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Wehrens KME, Noordzij SMJS, van der Hulst RRWJ. A typical case of bursitis. EUROPEAN JOURNAL OF PLASTIC SURGERY 2008. [DOI: 10.1007/s00238-008-0253-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Li PKL, James SLJ, Davies AM. Tumour and tumour-like lesions of the intercondylar notch of the knee: a pictorial review. J Med Imaging Radiat Oncol 2008; 52:434-46. [PMID: 19032388 DOI: 10.1111/j.1440-1673.2008.02000.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
A variety of tumours and tumour-like lesions are found in the intercondylar notch of the knee. MR imaging is the technique of choice in evaluating these conditions. Correlation with radiographs is important to identify those lesions containing calcification. This review article discusses the imaging features of tumour and tumour-like lesions involving the intercondylar notch with an emphasis on MR imaging features that suggest a specific diagnosis.
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Affiliation(s)
- P K L Li
- Department of Radiology, Royal Orthopaedic Hospital, Birmingham, UK.
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Huang GS, Lee HS, Hsu YC, Kao HW, Lee HH, Chen CY. Tenosynovial lipoma arborescens of the ankle in a child. Skeletal Radiol 2006; 35:244-7. [PMID: 16235076 DOI: 10.1007/s00256-005-0008-x] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2005] [Revised: 05/19/2005] [Accepted: 05/19/2005] [Indexed: 02/02/2023]
Abstract
Lipoma arborescens is a rare entity of the synovium and frequently occurs in the joints. Lipoma arborescens involving the synovial sheaths of the tendons is exceedingly rare. We report a case of a 12-year-old girl with lipoma arborescence affecting the synovial sheaths of the peroneal, posterior tibialis, and flexor tendons. Identification of the typical features of fat tissues in the proliferative synovium on MRI may help in making a correct diagnosis. The clinical presentation and MRI findings are described, and the entity is briefly reviewed.
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Affiliation(s)
- Guo-Shu Huang
- Department of Radiology, Tri-Service General Hospital, National Defense Medical Center, #325 Cheng-Kung Road Section 2, Neihu 114, Taipei, Taiwan, Republic of China.
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Bejia I, Younes M, Moussa A, Said M, Touzi M, Bergaoui N. Lipoma arborescens affecting multiple joints. Skeletal Radiol 2005; 34:536-8. [PMID: 15782340 DOI: 10.1007/s00256-005-0900-4] [Citation(s) in RCA: 48] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2004] [Revised: 12/24/2004] [Accepted: 01/10/2005] [Indexed: 02/02/2023]
Abstract
Lipoma arborescens is a rare benign intra-articular lesion of unknown etiology that usually involves the suprapatellar pouch of the knee joint. Clinically, the most common finding is a slow-growing painless swelling, accompanied by intermittent effusion of the joint. We report a case of a multifocal lipoma arborescens localized in the knees and the hips in a 24-year-old man, initially mimicking an inflammatory arthropathy. The diagnosis of lipoma arborescens was made by magnetic resonance imaging of the hips and the knees. Under arthroscopic guidance, the synovial biopsy of the right knee disclosed the specific histological signs of lipoma arborescens. As far as we know, this is the third case of multifocal lipoma arborescens reported in the English literature.
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Affiliation(s)
- Ismail Bejia
- Department of Rheumatology, EPS Monastir, Monastir, Tunisia.
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