Primary lipoma arborescens of the knee

Lipoma Arborescens: can we afford to miss it?

INTRODUCTION

Lipoma Arborescens is an extremely rare, benign lesion effecting the synovial tissue of joints. It is characterized by villous lipomatous proliferation of the synovial tissue. The aim of our study was to evaluate its diagnostic features and analyse the functional outcome of arthroscopic management.

METHODS

We studied 13 patients who were diagnosed to have lipoma arborescens at our institution during the period from October 2005 to October 2019. All patients underwent arthroscopic synovectomy. Histopathological examination confirmed the diagnosis. Pre-operative and post-operative functional assessment was done using Tegner Lysholm score.

RESULTS

Mean age was 46.6 years. All patients presented with progressive swelling of knee joint, while 6 patients also complained of pain. Average duration of symptoms was 34 months. All the patients were diagnosed based on MRI findings. Tegner Lysholm scoring at last follow up visit, had 11 patients with excellent outcome, 1 patient with good outcome, and 1 patient with fair outcome. None of the patients had recurrence, nor underwent any subsequent procedure of the operated joint.

CONCLUSIONS

Lipoma arborescens is a rare condition which should be a differential in patients with mono-articular swelling of the knee joint, and can be confirmed with MRI. It should not be misdiagnosed or missed at early stages as prolonged duration of symptoms and delay in treatment is likely to lead to development of secondary arthritis of the joint. Arthroscopic synovectomy showed good functional outcome and no recurrence.

Intra-articular Lipoma of the Knee Joint Located in the Lateral Recess: A Case Report

Introduction:

Lipomas are the most common type of soft-tissue tumor, but intra-articular lipomas are very rare. Most cases occur in the knee joint. This is a report of intra-articular lipoma in the knee joint, 8 months after removal with good post-operative outcome.

Case Report:

A 56-year-old female who presented soft-tissue mass on her right knee. She felt uncomfortable but not in pain. The mass grew gradually and she wanted to be surgically removed. The mass was too large (5 cm × 4 cm × 2 cm) to be removed endoscopically, so arthrotomy was made. The mass was true lipoma histologically. She is living happily without recurrence after surgery.

Conclusion:

We have described an intra-articular synovial lipoma in the knee of a middle-aged female. Intra-articular lipomas are very rare. The tumor in this case was relatively large but painless, and the chief complaint was discomfort. It grew gradually, so the removal was performed. At present, the patient is living happy without recurrence after surgery.