scholarly journals Hoffa’s Osteochondroma - Para-articular Extrasynovial Infrapatellar Fat Pad Osteochondroma: A Case Report

2021 ◽  
Vol 59 (240) ◽  
Author(s):  
Sunil Panta ◽  
Shrawan Kumar Thapa ◽  
Krishna Prasad Paudel ◽  
Manoj Kandel ◽  
Bishwa Raj Adhikari
Keyword(s):  
Case Reports ◽  
Complete Recovery ◽  
Infrapatellar Fat Pad ◽  
Fat Pad ◽  
Connective Tissues ◽  
One Year ◽  
Fibrous Tissues ◽  
Anterior Knee ◽  
Metaphyseal Region

Osteochondroma usually arises from the metaphyseal region of growing bones. The occurrence of extraskeletal osteochondroma is rare with very few case reports. Para-articular osteochondroma is a type of extraskeletal osteochondroma. It frequently occurs around the knee, usually at infrapatellar Hoffa’s fat pad. It is usually intracapsular but extrasynovial and arises from the capsule and connective tissues due to osteocartilaginous metaplasia. We present a case of 19-years male with anterior knee pain for 3 years, swelling, and deformity of the knee with flexion limitation for one year. Radiography revealed ovoid, corticated lesion free from adjoining bones. Mass interpreted as benign, so planned for excision. Well circumscribed nodule excised from the medial parapatellar approach. Histology revealed cartilaginous tissues surrounded by fibrous tissues with scattered enchondral ossification.Postoperatively and subsequent follow-up resulted in pain-free joint, complete recovery of range of motion with no clinicoradiological evidence of recurrence.

scholarly journals Giant Intra-Articular Extrasynovial Osteochondroma of the Knee: A Report of Two Cases

2011 ◽  
Vol 5 (1) ◽  
pp. 368-371 ◽  
Author(s):  
F De Maio ◽  
S Bisicchia ◽  
V Potenza ◽  
R Caterini ◽  
P Farsetti
Keyword(s):  
Range Of Motion ◽  
Anterior Part ◽  
Complete Recovery ◽  
Infrapatellar Fat Pad ◽  
Fat Pad ◽  
Hoffa’S Fat Pad ◽  
Longitudinal Approach ◽  
Bone Trabeculae ◽  
Inner Region

We report two cases of a giant extrasynovial osteochondroma of the knee located in the infrapatellar fat pad region, in two females who were 58 and 71 years old respectively. Both patients had noticed the mass many years before our first clinical observation. In both patients, at physical examination a solid, firm and hard mass was palpable in the anterior part of the knee in Hoffa’s fat pad region, and the range of motion of the knee was severely restricted and painful. CT scan examination with 3D-reconstruction showed two large, calcified neoformations behind the patellar tendon, between the apex of the patella and the proximal third of the tibia. In both cases, the mass was completely resected surgically through an anterior longitudinal approach. At histological examination, the excised masses consisted of an outer layer of hyaline cartilage without significant chondrocyte atypia and an inner region of bone trabeculae formed by endochondral ossification. At follow-up, 8 and 4 years after the operation, both patients were pain-free, with complete recovery of the range of motion of the knee and without any clinical or radiographic evidence of recurrence. The authors believe that intra-articular extrasynovial osteochondroma of the knee is a primary metaplasia of Hoffa’s fat pad. Usually, the tumor develops slowly and asymptomatically over many years. The treatment of choice is a marginal resection of the mass, although a biopsy should be considered in some cases. Recurrences are extremely rare.

scholarly journals Case Report: Bladder adenocarcinoma: primary or urachal?

F1000Research ◽  
2019 ◽  
Vol 8 ◽  
pp. 1717
Author(s):  
J. Eduardo Tejeda-Mariaca ◽  
Marco Ordoñez-Alcantara ◽  
Aldo Bello-Sedano ◽  
Victor Perez-Cornejo ◽  
J. Antonio Grandez-Urbina
Keyword(s):  
Incidental Finding ◽  
Case Reports ◽  
Complete Recovery ◽  
Partial Cystectomy ◽  
Prior History ◽  
Pathology Report ◽  
Histological Variant ◽  
One Year ◽  
Bladder Adenocarcinoma

Background: Bladder adenocarcinoma (AC) is a scarce histological variant and there are few studies on its proper management. No previous case reports present the management of a urachal tumor and the incidental finding of bladder adenocarcinoma. Clinical case: We present the case of a young woman with nonspecific symptoms, who presented with a prior history of dysuria, bladder tenesmus, suprapubic pain and urinary urgency for one year, which had been treated as recurrent urinary tract infection. A partial cystectomy plus extended lymphadenectomy was scheduled. We found a bladder tumor with characteristics of a urachal tumor and the pathological report indicated a primary bladder AC. The patient had a complete recovery at one year of follow-up. Conclusions: A patient can present with a tumor with urachal characteristics; however, the pathology report can show primary AC. The decision to perform partial cystectomy was an appropriate option for the location of this tumor, with optimal surgical results. Still, a long-term follow-up is necessary. More specific management guidelines are required for the treatment of AC.

Infrapatellar Fat Pad Impingement: A Systematic Review

2017 ◽  
Vol 30 (07) ◽  
pp. 639-646 ◽  
Author(s):  
Jason Genin ◽  
Mhamad Faour ◽  
Prem Ramkumar ◽  
George Yakubek ◽  
Anton Khlopas ◽  
...  
Keyword(s):  
Systematic Review ◽  
Knee Pain ◽  
Anterior Knee Pain ◽  
Clinical Presentation ◽  
Infrapatellar Fat Pad ◽  
Lateral Side ◽  
Imaging Findings ◽  
Fat Pad ◽  
Knee Pathology ◽  
Anterior Knee

AbstractInfrapatellar fat pad impingement represents a source of anterior knee pain that is often overlooked. Due to the scarcity of reports related to this disorder, we conducted a systematic review of the literature related to infrapatellar fat pad impingement in evaluating the following: (1) clinical presentation, (2) imaging, (3) management, and (4) clinical outcomes. A systematic review was conducted investigating all available primary literature related to the clinical presentation, imaging, management, and outcomes of infrapatellar fat pad impingement syndrome. A total of 15 studies (9 case reports, 1 case series, and 5 retrospective studies) comprising 167 patients met eligibility criteria for this review. Patients with infrapatellar fat pad impingement were found to most often present with anterior knee pain that worsened with activity, and was frequently associated with trauma. Anterior knee pain, tenderness to palpation over the patellar tendon, loss in terminal extension, and pain with direct pressure on the medial or lateral side of the patella with the knee extended was often found on examination. Although patients may have classic imaging findings on magnetic resonance imaging (localized edema of the infrapatellar fat pad, deep fluid-filled infrapatellar bursa, nonvisualization of clefts, fibrosis, and calcifications), not all patients had positive imaging findings, thus making infrapatellar fat pad impingement a clinical diagnosis. Treatment begins with nonoperative management, but in recalcitrant cases, patients can be surgically treated with arthroscopic fat pad resection. Most patients who undergo operative treatment report improvement or complete resolution of symptoms in terms of pain and range of motion, and are able to return to work. To the best of our knowledge, this is the first comprehensive review on infrapatellar fat pad impingement to better aid the orthopaedic surgeons in diagnosing, treating, and managing patient expectations for this often overlooked knee pathology.

Tibial nailing using a suprapatellar rather than an infrapatellar approach significantly reduces anterior knee pain postoperatively: a multicentre clinical trial

2019 ◽  
Vol 101-B (9) ◽  
pp. 1138-1143 ◽  
Author(s):  
D. R. W. MacDonald ◽  
P. Caba-Doussoux ◽  
C. A. Carnegie ◽  
I. Escriba ◽  
D. P. Forward ◽  
...  
Keyword(s):  
Knee Pain ◽  
Anterior Knee Pain ◽  
Tibial Fracture ◽  
Patient Reported Outcome ◽  
Surgical Approaches ◽  
Patient Reported ◽  
Suprapatellar Approach ◽  
One Year ◽  
Anterior Knee

Aims The aim of this study was to compare the incidence of anterior knee pain after antegrade tibial nailing using suprapatellar and infrapatellar surgical approaches Patients and Methods A total of 95 patients with a tibial fracture requiring an intramedullary nail were randomized to treatment using a supra- or infrapatellar approach. Anterior knee pain was assessed at four and six months, and one year postoperatively, using the Aberdeen Weightbearing Test – Knee (AWT-K) score and a visual analogue scale (VAS) score for pain. The AWT-K is an objective patient-reported outcome measure that uses weight transmitted through the knee when kneeling as a surrogate for anterior knee pain. Results A total of 53 patients were randomized to a suprapatellar approach and 42 to an infrapatellar approach. AWT-K results showed a greater mean proportion of weight transmitted through the injured leg compared with the uninjured leg when kneeling in the suprapatellar group compared with the infrapatellar group at all timepoints at all follow-up visits. This reached significance at four months for all timepoints except 30 seconds. It also reached significance at six months at 0 seconds, and for one year at 60 seconds. Conclusion The suprapatellar surgical approach for antegrade tibial nailing is associated with less anterior knee pain postoperatively compared with the infrapatellar approach Cite this article: Bone Joint J 2019;101-B:1138–1143

scholarly journals Sertoli-Leydig Cell Tumor with Concurrent Rhabdomyosarcoma: Three Case Reports and a Review of the Literature

2017 ◽  
Vol 2017 ◽  
pp. 1-6 ◽  
Author(s):  
Trisha Plastini ◽  
Arthur Staddon
Keyword(s):  
Leydig Cell ◽  
Malignant Tumors ◽  
Case Reports ◽  
Treatment Options ◽  
Treatment Strategies ◽  
Salvage Chemotherapy ◽  
Response To Chemotherapy ◽  
One Year ◽  
Lost To Follow Up

Sertoli-Leydig Cell Tumors (SLCTs) make up <1% of all ovarian tumors and are benign or malignant, androgen-secreting tumors. Rhabdomyosarcoma (RMS) is a heterogeneous group of malignant tumors that resemble developing skeletal muscle. There have been case reports of patients with concurrent SLCT and RMS with limited treatment options. We aim to demonstrate treatment strategies used in our patients, which seemed to have prolonged survival when compared to prior case reports of patients not cured by surgical resection. Herein we describe 22 cases of SLCT with RMS elements as discussed in prior case reports and three cases from the authors’ institution. Of the 19 cases from prior case reports, five were lost to follow-up and two had NED after surgical intervention. Eleven patients had recurrence and were deceased within one year. Of those patients not surgically cured, only three patients were documented as living beyond two years, all of whom received chemotherapy. The three patients presented from our institution had clinical evidence of response to chemotherapy that is traditionally used for RMS. In conclusion, chemotherapy with doxorubicin and ifosfamide has activity in patients with SLCT and RMS as does salvage chemotherapy with vincristine, irinotecan, and temozolomide.

scholarly journals Quantitative functional outcomes of the conservative management of partial segmental thrombosis of the corpus cavernosum

2015 ◽  
Vol 97 (7) ◽  
pp. e108-e111 ◽  
Author(s):  
H Gresty ◽  
S Tadtayev ◽  
N Arumainayagam ◽  
S Patel ◽  
C King ◽  
...  
Keyword(s):  
Sexual Function ◽  
Conservative Management ◽  
Erectile Function ◽  
Functional Outcomes ◽  
Case Reports ◽  
Formal Analysis ◽  
Corpus Cavernosum ◽  
Complete Recovery ◽  
Low Incidence

The low incidence of partial segmental thrombosis of the corpus cavernosum (PSTCC) means its management is guided by isolated case reports. Erectile function is an important outcome that has not been described quantitatively in the literature. We present two cases of PSTCC managed conservatively. Although both patients reported resolution of local symptoms, formal analysis of sexual function at follow-up review has revealed that only one achieved complete recovery.

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