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复发性髌下脂肪体滑膜软骨瘤病。

Recurrence of synovial chondromatosis of the Hoffa's body.

机构信息

Unit of Arthroscopy and Sports Trauma Surgery, Hesperia Hospital, Via Arquà 80/b, Modena, Italy.

出版信息

Knee Surg Sports Traumatol Arthrosc. 2009 Dec;17(12):1421-4. doi: 10.1007/s00167-009-0859-0. Epub 2009 Jul 10.

Abstract

Synovial chondromatosis of Hoffa's body is uncommon. Recurrences usually result from incomplete removal of the loose bodies or diseased synovium at the initial surgery. We report a patient with synovial chondromatosis localized into the Hoffa's body who presented with anterior knee pain and mechanical symptoms. At the first arthroscopy, all pathological tissue was removed. At 1-year follow-up, clinical and radiographic examinations were normal. Symptoms recurred at 3 years, when a bony mass in the Hoffa's body was evident on MRI. The mass was removed through a mini-arthrotomy. Histology excluded malignancy. At 10-year follow-up, the patient remained free of symptoms. Synovial chondromatosis can occur with unusual patterns of recurrence. The growth of a large size mass confined to fat pad without intra-articular involvement does not allow to exclude the diagnosis of recurrent synovial chondromatosis.

摘要

髌下脂肪垫滑膜软骨瘤病较为少见。初次手术时,如果游离体或病变滑膜切除不彻底,通常会导致疾病复发。我们报告了 1 例局限于髌下脂肪垫的滑膜软骨瘤病患者,其表现为膝关节前侧疼痛和机械性症状。初次关节镜检查时,所有病理组织均被切除。1 年随访时,临床和影像学检查均正常。3 年后症状再次出现,MRI 显示髌下脂肪垫内有骨块。通过小切口关节切开术切除了该骨块。组织学检查排除了恶性肿瘤。10 年随访时,患者无任何症状。滑膜软骨瘤病的复发模式可能较为特殊。局限于脂肪垫、无关节内受累的较大肿块的生长并不能排除复发性滑膜软骨瘤病的诊断。

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