Surgical management of upper limb lipoma arborescens: a systematic review

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.

Lipoma Arborescens Might Be an Unusual Cause of Knee Pain in Adolescents: A Case Report

“…The patient under examination presents a series of atypical aspects, unlike the classic presentation of the LA. First of all, the average age of onset is between the fourth and fifth decade of life, while the patient presented is a 16-year-old young man [10]. Secondly, the presence of ROM limitation and joint pain and swelling does not occur so frequently in patients with LA [11].…”

Surgical treatment of distal hamstring tendon injuries yield a higher return‐to‐sports rate: A systematic review

“…The quantitative content assessment was performed by two independent investigators using Murad's tool to evaluate the methodological quality of case reports and case series, a modified version of the Newcastle-Ottawa Scale (Table 1) [29]. This scale has been used recently in systematic reviews of case reports and case series [19]. The tool has five questions with dichotomic answers.…”