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Undiagnosed synovial hemangioma of the knee: a case report

BACKGROUND: Synovial hemangioma of the knee is a rare benign tumor. Very rarely, the growth of bone is affected by long-term neglect of an intra-articular tumor. Our patient had not only various clinical symptoms but also dysplasia of the femoral bone. In this report, we aimed to raise awareness to...

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Autores principales: Tohma, Yasuaki, Mii, Yoshio, Tanaka, Yasuhito
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6636119/
https://www.ncbi.nlm.nih.gov/pubmed/31311579
http://dx.doi.org/10.1186/s13256-019-2107-7
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author Tohma, Yasuaki
Mii, Yoshio
Tanaka, Yasuhito
author_facet Tohma, Yasuaki
Mii, Yoshio
Tanaka, Yasuhito
author_sort Tohma, Yasuaki
collection PubMed
description BACKGROUND: Synovial hemangioma of the knee is a rare benign tumor. Very rarely, the growth of bone is affected by long-term neglect of an intra-articular tumor. Our patient had not only various clinical symptoms but also dysplasia of the femoral bone. In this report, we aimed to raise awareness to prevent various disorders arising from an unnoticed or untreated hemangioma occurring within the knee joint. CASE PRESENTATION: Our patient was a 41-year-old Japanese man who had had occasional discomfort in the right knee since elementary school. Although he had undergone radiography at several hospitals since childhood, no issues were reported; subsequently, he consulted our hospital. We performed magnetic resonance imaging and discovered a mass. The mass was homogeneous with low intensity on T1-weighted sequences and high intensity on T2-weighted sequences adjacent to the medial femoral condyle. The shape of the medial femoral condyle presented with a concavity in axial images, with irregular margins from the patellofemoral joint to the medial femoral condyle. Moreover, by using magnetic resonance angiography, we discovered a second mass. We decided to perform open surgery to achieve complete excision. Histological examination indicated a synovial hemangioma involving a cavernous hemangioma and irregular arteriovenous connections originating from the subsynovial tissue. The patient became asymptomatic after surgery, with no recurrence for more than 4 years. CONCLUSIONS: Synovial hemangioma is rare and difficult to diagnose in outpatient examinations because radiography has a limited diagnostic capacity. Magnetic resonance imaging and angiography are very useful. Nontreatment of intra-articular hemangiomas may lead to dysplasia of the bone and various clinical symptoms. Early complete excision may be instituted to reduce these risks of hemarthrosis.
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spelling pubmed-66361192019-07-25 Undiagnosed synovial hemangioma of the knee: a case report Tohma, Yasuaki Mii, Yoshio Tanaka, Yasuhito J Med Case Rep Case Report BACKGROUND: Synovial hemangioma of the knee is a rare benign tumor. Very rarely, the growth of bone is affected by long-term neglect of an intra-articular tumor. Our patient had not only various clinical symptoms but also dysplasia of the femoral bone. In this report, we aimed to raise awareness to prevent various disorders arising from an unnoticed or untreated hemangioma occurring within the knee joint. CASE PRESENTATION: Our patient was a 41-year-old Japanese man who had had occasional discomfort in the right knee since elementary school. Although he had undergone radiography at several hospitals since childhood, no issues were reported; subsequently, he consulted our hospital. We performed magnetic resonance imaging and discovered a mass. The mass was homogeneous with low intensity on T1-weighted sequences and high intensity on T2-weighted sequences adjacent to the medial femoral condyle. The shape of the medial femoral condyle presented with a concavity in axial images, with irregular margins from the patellofemoral joint to the medial femoral condyle. Moreover, by using magnetic resonance angiography, we discovered a second mass. We decided to perform open surgery to achieve complete excision. Histological examination indicated a synovial hemangioma involving a cavernous hemangioma and irregular arteriovenous connections originating from the subsynovial tissue. The patient became asymptomatic after surgery, with no recurrence for more than 4 years. CONCLUSIONS: Synovial hemangioma is rare and difficult to diagnose in outpatient examinations because radiography has a limited diagnostic capacity. Magnetic resonance imaging and angiography are very useful. Nontreatment of intra-articular hemangiomas may lead to dysplasia of the bone and various clinical symptoms. Early complete excision may be instituted to reduce these risks of hemarthrosis. BioMed Central 2019-07-17 /pmc/articles/PMC6636119/ /pubmed/31311579 http://dx.doi.org/10.1186/s13256-019-2107-7 Text en © The Author(s). 2019 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Case Report
Tohma, Yasuaki
Mii, Yoshio
Tanaka, Yasuhito
Undiagnosed synovial hemangioma of the knee: a case report
title Undiagnosed synovial hemangioma of the knee: a case report
title_full Undiagnosed synovial hemangioma of the knee: a case report
title_fullStr Undiagnosed synovial hemangioma of the knee: a case report
title_full_unstemmed Undiagnosed synovial hemangioma of the knee: a case report
title_short Undiagnosed synovial hemangioma of the knee: a case report
title_sort undiagnosed synovial hemangioma of the knee: a case report
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6636119/
https://www.ncbi.nlm.nih.gov/pubmed/31311579
http://dx.doi.org/10.1186/s13256-019-2107-7
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