A rare case of hibernoma in the posterior thigh of an elderly patient: A surgical case report.

INTRODUCTION AND IMPORTANCE: Hibernoma is a rare benign adipose tumor that arises from brown fat. Often misdiagnosed as liposarcoma, hibernomas require biopsy and histopathological examination for accurate diagnosis. This case report presents an unusual instance of hibernoma located in the posterior thigh of an elderly patient, emphasizing the diagnostic challenges and surgical management involved. CASE PRESENTATION: We report the case of Mrs. F.D., a 70-year-old woman with a history of ovarian cyst surgery 17 years prior, who presented with a mass in the posterior left thigh. The mass had been developing over two years and was hard, painless, and measured 7 × 12 cm. Initial imaging suggested liposarcoma; however, an MRI revealed a 9 × 19 cm mass with heterogeneous tissue characteristics. A surgical biopsy confirmed the diagnosis of hibernoma. The tumor was excised completely, and histological examination showed typical features of hibernoma. CLINICAL DISCUSSION: Hibernomas, although rare, should be considered in the differential diagnosis of soft tissue masses. Imaging techniques such as MRI are essential, but definitive diagnosis relies on histopathology. Surgical excision is the treatment of choice, requiring meticulous technique to manage the hypervascular nature of the tumor. CONCLUSION: This case underscores the importance of considering hibernoma in differential diagnoses and highlights the role of biopsy for accurate diagnosis. Complete surgical excision is crucial to prevent recurrence. Further research is needed to better understand the pathogenesis and optimal management of hibernomas.

Concurrent arboreal lipoma and synovial chondromatosis in an osteoarthritic knee: Insights from a rare case study - A surgical case report.

INTRODUCTION AND IMPORTANCE: Conditions mimicking tumors within the knee, such as arborescent lipoma and synovial chondromatosis, are generally benign yet closely linked to inflammatory or degenerative joint diseases. While each condition is commonly documented individually with osteoarthritis, their concurrent presentation within the same knee is extremely rare. This case report adheres to the SCARE 2023 guidelines (Sohrabi et al., 2023) and aims to shed light on the diagnostic and therapeutic challenges posed by the rare coexistence of these conditions, presenting unique management challenges. CASE PRESENTATION: We detail the case of a 67-year-old woman who has been suffering from progressively worsening bilateral osteoarthritis for over five years, with significant impairment in her right knee. Symptoms included persistent pain unresponsive to standard treatments, reduced mobility, and recurrent swelling. A comprehensive diagnostic evaluation through clinical examination, radiography, and magnetic resonance imaging (MRI) suggested tricompartmental osteoarthritis complicated by suspected arborescent lipoma. Surgical exploration not only confirmed the presence of arborescent lipoma but also revealed synovial chondromatosis. Both conditions were validated during total knee arthroplasty via histopathological examination, and the patient demonstrated significant functional recovery 18 months postoperatively. CLINICAL DISCUSSION: The simultaneous occurrence of arborescent lipoma and synovial chondromatosis within an osteoarthritic knee emphasizes the complex nature of diagnosing and managing advanced joint pathologies. This case highlights the critical need for thorough diagnostic processes to differentiate between multiple potential diagnoses and the vital role of surgical intervention in managing such intricate conditions effectively. CONCLUSION: The rare coexistence of arborescent lipoma and synovial chondromatosis in an osteoarthritic knee underlines the complexities of diagnosing and managing joint diseases. It accentuates the necessity of an exhaustive diagnostic approach and demonstrates the efficacy of surgical management in achieving favorable outcomes. This case supports the need for maintaining a broad differential diagnosis and underscores the value of interdisciplinary collaboration in managing complex joint pathologies.

Two years neglected knee dislocation: An unusual case report.

INTRODUCTION: Traumatic dislocation of the knee is a rare and severe injury, often caused by a severe trauma. Neglected knee dislocations are much more uncommon and treatment options are not clearly described. PRESENTATION OF CASE: We reported the case of a 26-year-old man with two years neglected knee dislocation which was managed with open reduction and stabilization with external fixation and intra-articular Steinman pins for six weeks. DISCUSSION AND CONCLUSION: Knee dislocations are rare injuries that can be underestimated during the emergency assessment, particularly in the absence of neurovascular injuries, which usually lead to surgical treatment, or the presence of severe trauma that disguises dislocation as the case for our patient. Only a high clinical suspicion can avoid neglecting the more severe joint injury.

Intra-articular lipoma arborescens of the knee: A report of two cases with bilateral localization.

INTRODUCTION: Lipoma arborescens is a very rare pseudo-tumoral lesion of unknown etiology, characterized by lipomatous infiltration of subsynovial stroma, bilateral involvement is exceptional, only eight cases are reported in the literature. PRESENTATION OF CASE: We report the very rare case of two men presented at our department with complaints of swelling of both knees and intermittent joint effusion, Surgical biopsy revealed Lipoma arborescens in both cases. Open total synovectomy was performed. Follow-up evaluation showed no signs of recurrence. DISCUSSION AND CONCLUSION: Lipoma arborescens is a rare entity, the unilateral form affecting the knee is the most common, with a predilection for suprapellar recess. Magnetic resonance imaging (MRI) is the examination of choice showing multiple villous proliferation of the synovium and fat-like cells, with a fatty signal on all sequences. Treatment by open or arthroscopic synovectomy offers the best outcomes.