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Case Reports
. 2017 Mar 19;53(2):252-256.
doi: 10.1016/j.rboe.2017.03.011. eCollection 2018 Mar-Apr.

Lipoma arborescens of the elbow: a case with features of a high-grade tumor

Wagner Santana Cerqueira  1 , Rayssa Araruna Bezerra de Melo  1 , Felipe D'Almeida Costa  1 , Juliane Comunello  1 , Almir Galvão Vieira Bitencourt  1 , Wu Tu Chung  1
Affiliations
Case Reports

Lipoma arborescens of the elbow: a case with features of a high-grade tumor

Wagner Santana Cerqueira et al. Rev Bras Ortop. .

Abstract
in English, Portuguese

Lipoma arborescens (LA) is an uncommon non-neoplastic disorder that may affect almost any joint, mainly the knee. LA is very rare in the elbow, and there are only a few cases reported in the literature. This study aimed to describe a case of LA in the elbow, presenting with features of a high-grade tumor. The authors report the case of a 51-years-old male who presented to this institution with pain and swelling on the left elbow. The patient had a seven-year history of investigation, with inconclusive diagnosis. Magnetic resonance imaging (MRI) showed an expansive mass with local aggressiveness. Due to these characteristics, it was not possible to discard soft tissue sarcoma at the differential diagnosis. After biopsy and a multidisciplinary team meeting, the authors opted for surgical resection. The final anatomopathological result confirmed the diagnosis of LA. Despite not being a true neoplasm, LA can cause many symptoms and functional impairment of the affected joint. It is important to keep this diagnosis in mind when any expansive mass surrounding a joint is observed.

O lipoma arborescens (LA) é uma doença não-neoplásica incomum que pode afetar quase todas as articulações, principalmente o joelho. O LA é muito raro no cotovelo e há apenas alguns casos relatados na literatura. O objetivo deste estudo é descrever um caso de LA no cotovelo, apresentando características de tumor de alto grau. Os autores relatam o caso de um homem de 51 anos de idade que se apresentou à instituição com dor e inchaço no cotovelo esquerdo. O paciente tinha sete anos de história de investigação com diagnóstico inconclusivo. As características da ressonância magnética (RM) mostraram uma massa expansiva com agressividade local. Devido a estas características, não foi possível descartar sarcoma de tecido mole no diagnóstico diferencial. Após a biópsia e uma reunião de equipe multidisciplinar, optou-se pela ressecção cirúrgica. O resultado anatomopatológico final confirmou o diagnóstico de LA. Mesmo que não seja uma neoplasia verdadeira, o LA pode causar muitos sintomas com comprometimento funcional da articulação afetada. É importante ter em mente este diagnóstico quando qualquer massa expansiva em torno de uma articulação for observada.

Keywords: Elbow joint; Lipoma; Magnetic resonance imaging.

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Figures

Fig. 1
Fig. 1
Magnetic resonance imaging of the elbow showed an ill-defined mass at the distal portion of the bicipital tendon associated with fat proliferation within the bicipitoradial bursa and erosion of the radio tuberosity with subtle edema of bone marrow. (A) Axial image FSE T1; (B) axial image T2 SPAIR; (C) axial T1 post contrast; (D) coronal image T1; (E) coronal imagem T2 SPAIR.
Fig. 2
Fig. 2
(A) Histologically, the biopsy showed well defined nodules of mature adipose tissue expanding the synovium; (B) the surface of the nodules was villous and covered by synoviocytes.
Fig. 3
Fig. 3
Intraoperative images before (A) and after (B) tumor dissection. 1, radial nerve; 2, brachial artery; 3, supinator muscle; 4, biceps brachii muscle tendon; 5, tumor; 6, tumor bed after resection.
Fig. 4
Fig. 4
(A) The microscopic examination of the surgical specimen revealed a multilobulated lesion composed of adipose tissue nodules mixed with focal fibrosis and chronic inflammation; (B) the synoviocytes at the surface of the nodules allowed the identification of a proliferative synovial lesion full of typical adipocytes within the stroma, confirming the diagnosis of Lipoma arborescens.
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References

    1. Van Landeghem A., Arys B., Heyse C., Peters N., Huysse W. Lipoma arborescens. JBR-BTR. 2013;96(4):254–255. - PubMed
    1. Sanamandra S.K., Ong K.O. Lipoma arborescens. Singapore Med J. 2014;55(1):5–10. - PMC - PubMed
    1. Le Corroller T., Gaubert J.Y., Champsaur P., Gravier R., Airaudi S., Argenson J.N. Lipoma arborescens in the bicipitoradial bursa of the elbow: sonographic findings. J Ultrasound Med. 2011;30(1):116–118. - PubMed
    1. Ranganath K., Rao G.B., Namitha Lipoma arborescens of the elbow. Indian J Radiol Imaging. 2010;20(1):50–52. - PMC - PubMed
    1. Doyle A.J., Miller M.V., French J.G. Lipoma arborescens in the bicipital bursa of the elbow: MRI findings in two cases. Skeletal Radiol. 2002;31(11):656–660. - PubMed

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