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Case Reports
. 2019 Jan-Feb;9(1):28-32.
doi: 10.13107/jocr.2250-0685.1294.

Hoffa's Fat Pad-associated Solitary Neurofibroma as the Cause of Anterior Knee Pain: A Case Report

Romeo Tecualt-Gómez  1 , Adriana Atencio-Chan  2 , Gabriela Gutiérrez-Salmeán  3
Affiliations
Case Reports

Hoffa's Fat Pad-associated Solitary Neurofibroma as the Cause of Anterior Knee Pain: A Case Report

Romeo Tecualt-Gómez et al. J Orthop Case Rep. 2019 Jan-Feb.

Abstract

Introduction: Infrapatellar peripheral neural tumors, particularly neurofibromas, are rather rare entities reported in the literature. They are slow-growing lesions that usually do not exhibit clinical manifestations other than interspecific swelling or pain; hence, their diagnosis can be quite challenging. Therefore, scrutiny should include not only traditional clinical assessment and imaging but also more specific molecular biology techniques, such as immunohistochemistry.

Case report: We present the clinical, imaging, histological, and immunohistochemical features of a unique case of solitary neurofibromain a 33-year-old female presenting chronic anterior knee pain. The tumor was completely removed through a surgical approach.

Conclusions: Although cases of a solitary neurofibroma originating within Hoffa's fat pad are extremely rare; the entity should be considered in the differential diagnosis when symptomatology is not alleviated with appropriate treatments.

Keywords: Anterior knee pain; Hoffa’s fat pad; immunohistochemistry; solitary neurofibroma.

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Conflict of interest statement

Conflict of Interest: Nil

Figures

Figure 1
Figure 1
(a) Lateral, (b) anterior, and (c) transversal views of magnetic resonance imaging using gadolinium-based contrast medium.
Figure 2
Figure 2
H and E staining for transoperatory incisional biopsy.
Figure 3
Figure 3
Immunohistochemistry staining for (a) PS100, (b) CD34, (c) EMA, and (d) GFAP antibodies.
Figure 4
Figure 4
Surgical excision of the neoplasm: (a) Anterior knee approach and (b) Hoffa’s fat pad wide resection.
Figure 5
Figure 5
(a) Real-time -i.e., fresh- external surface of Hoffa’s fat pad and (b) fixed -10% paraformaldehyde buffer- and stained tissue for margin delimitation.
Figure 6
Figure 6
H and E staining for definite excisional diagnosis.
Figure 7
Figure 7
Postsurgical clinical evolution of the knee: (a) 1 day, (b) 1 week, (c and d) 2 weeks, (e) 3 weeks, and (f) 1 month after intervention.
See this image and copyright information in PMC

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