An unusual case of lipoma arborescens

Mohammad, H R; Chaturvedi, Apeksha; Peach, Ceri

doi:10.1308/rcsann.2016.0176

Cited by 12 publications

(21 citation statements)

References 5 publications

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“…The knee joint appears to be the most commonly involved area [18] (see ▶ Fig. 3), although cases of affected ankle [19], shoulder [20], wrist [21], hip [22], foot [23] and elbow joints [24] have also been reported. Tendon sheaths and bursae may also be involved.…”

Section: Clinical Presentationmentioning

confidence: 99%

Lipoma arborescens – Uncommon Diagnosis for Joint Swelling: Case Report and Review of the Literature

et al. 2019

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Introduction Soft tissue swelling of the knee joint can be caused by many diseases. Lipomas are one of the most reasonable differential diagnoses we have to consider. Therefore, we now present the uncommon case of a Lipoma arborescens (LA) and differentiate it from a quite similar manifesting spindle cell lipoma as follows. Case Report A 49-years old patient reports about progressive knee pain for four years and observes an increasing joint swelling. This swelling is a soft tissue, shiftable tumour, not painful. The magnetic resonance imaging (MRI) with contrast agent brings the diagnosis of an advanced osteoarthritis of the knee joint and classifies the tumour as LA. Subsequently, we treat the osteoarthritis by implanting a total knee arthroplasty with simultaneous intraoperative tumour resection performed as total synovectomy. The histopathological processing confirms the clinically and radiologically made diagnosis of LA. Summary Lipoma arborescens presents an uncommon subgroup of Lipomas, which is characterized by a slowly progressive increasing soft tissue swelling, especially around bigger human joints. Due to its intraarticular location, the LA might become clinically relevant when it reaches a certain tumour size. Looking at the diagnostics, sonography, MRI and especially the histopathological processing give the crucial results. Final proof can only be made by histopathological examination. Additionally, we have some differential diagnoses to exclude. Under these we predominantly find the spindle cell lipoma, synovial haemagioma, vascular synovial malformations and tenosynovial giant-cell tumour. Furthermore, an atypical lipomatous tumour should be excluded by FISH-analysis via determining the MDM2-Genamplification.

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Section: Clinical Presentationmentioning

confidence: 99%

Lipoma arborescens – Uncommon Diagnosis for Joint Swelling: Case Report and Review of the Literature

et al. 2019

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“…[ 1 , 2 ] In the latter, the few reports in the current literature mainly involve the bicipitoradial bursa and only one case report documents the outcome after open surgery for such manifestation. [ 3 ] We present an unusual case of a 54-year-old man with a history of rheumatoid arthritis (RA) presenting with a severe refractory LA involving the whole elbow, causing mechanical posterior humeroulnar impingement, successfully treated with arthroscopic synovectomy and olecranon plasty. This is to the best of the authors’ knowledge the first fully reported and illustrated case about arthroscopic treatment of elbow LA.…”

Section: Introductionmentioning

confidence: 99%

Arthroscopic treatment of a lipoma arborescens of the elbow

Paccaud¹,

Cunningham

2020

Medicine

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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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“…All patients had single lesion; one has a bilateral presentation [ 26 ]. Eleven lesions (50%) were located in the shoulder [ 1 – 3 , 22 , 24 , 28 , 30 , 32 , 33 , 35 , 36 ], seven (31.82%) in the elbow [ 13 , 23 , 25 , 26 , 29 , 34 ], and four (18.18%) in the wrist [ 14 , 27 , 31 , 37 ]. All patients but one had preoperative MRI scans during the diagnostic assessment [ 27 ].…”

Section: Resultsmentioning

confidence: 99%

“…Concomitant rotator cuff tears were reported in five patients [ 1 , 3 , 24 , 35 , 38 ]. Similarly, a labral tear [ 33 ], a long head biceps tendon fraying [ 32 ], and a distal biceps pathology [ 34 ] were concomitant lesions to the LA. Most studies evaluated the restoration of range of motion and symptom resolution for the functional outcome assessment.…”

Section: Resultsmentioning

confidence: 99%

Surgical management of upper limb lipoma arborescens: a systematic review

et al. 2022

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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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An unusual case of lipoma arborescens

Cited by 12 publications

References 5 publications

Lipoma arborescens – Uncommon Diagnosis for Joint Swelling: Case Report and Review of the Literature

Lipoma arborescens – Uncommon Diagnosis for Joint Swelling: Case Report and Review of the Literature

Arthroscopic treatment of a lipoma arborescens of the elbow

Surgical management of upper limb lipoma arborescens: a systematic review

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