de Andrade Marco A P, Reis Igor G N, de Andrade Luciene Mota, de Oliveira Campos Túlio Vinícius, Pimenta Frederico Silva, de Abreu E Silva Guilherme Moreira
Departamento do Aparelho Locomotor, Faculty of Medicine, Hospital das Clínicas, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.
Video J Sports Med. 2023 Nov 20;3(6):26350254231201426. doi: 10.1177/26350254231201426. eCollection 2023 Nov-Dec.
Synovial hemangioma is a rare neoplastic lesion, which can result in recurrent hemarthrosis and pain. It can affect any joint, tendon, or bursa, withal those around the knee. The intra-articular lesion is more prevalent and is more frequently diagnosed in female children or young adults.
Surgery is indicated when patients present with recurrent painful hemarthrosis that affect daily living and functionality.
Diagnostic knee arthroscopy, initially without tourniquet inflation, was performed to detect and study the extent of the lesion. Afterwards, the tourniquet was inflated to proceed with the surgical excision. Medial parapatellar approach was performed, and limits of the hemangioma were identified. Wide resection was performed taking care to not damage the medial meniscus and medial condyle cartilage. Neoplastic lesion was sent to pathology analysis. The tourniquet was deflated and hemostasis checked because these lesions can present extensive bleeding.
Localized, well-circumscribed, and encapsulated lesions have been reported to usually present low recurrence rate when completely excised.
DISCUSSION/CONCLUSION: It is a rare disease, and around 200 cases have been reported; therefore, conclusions about treatment and outcomes rely mostly on case series and case reports. Early diagnosis and treatment are paramount to prevent degenerative changes secondary to recurrent hemarthrosis.
The author(s) attests that consent has been obtained from any patient(s) appearing in this publication. If the individual may be identifiable, the author(s) has included a statement of release or other written form of approval from the patient(s) with this submission for publication.
滑膜血管瘤是一种罕见的肿瘤性病变,可导致反复关节积血和疼痛。它可累及任何关节、肌腱或滑囊,尤其是膝关节周围的。关节内病变更为常见,在女童或年轻成人中更常被诊断出来。
当患者出现影响日常生活和功能的反复疼痛性关节积血时,建议进行手术。
首先在不使用止血带充气的情况下进行诊断性膝关节镜检查,以检测和研究病变范围。之后,充气止血带以进行手术切除。采用内侧髌旁入路,确定血管瘤的边界。进行广泛切除,注意不要损伤内侧半月板和内侧髁软骨。将肿瘤性病变送去做病理分析。松开止血带并检查止血情况,因为这些病变可能会出现大量出血。
据报道,局限性、边界清楚且有包膜的病变在完全切除后通常复发率较低。
讨论/结论:这是一种罕见疾病,已报道约200例;因此,关于治疗和结果的结论主要依赖于病例系列和病例报告。早期诊断和治疗对于预防反复关节积血继发的退行性改变至关重要。
作者证明已获得本出版物中出现的任何患者的同意。如果个人可能被识别,作者已随本提交发表的文章附上患者的豁免声明或其他书面批准形式。