Extra-articular soft tissue ganglion cyst around the knee: focus on the associated findings

Kim, Jee Young; Jung, Sun-Ah; Sung, Mi-Sook; Park, Young-Ha; Kang, Yong-Koo

doi:10.1007/s00330-003-1969-6

Cited by 46 publications

(38 citation statements)

References 19 publications

(34 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In the benign category, ganglia form a significant component of myxoid lesions and can be confused with myxomas even on histology [2,8]. Although myxomas are more likely to be intramuscular, extramuscular myxomas [1,2,22] and intramuscular ganglia [15,19,23,24] are recognised in the literature, albeit they are uncommon. Perilesional oedema is not a specific finding for myxomas.…”

Section: Discussionmentioning

confidence: 94%

Soft tissue masses with “cyst-like” appearance on MR imaging: distinction of benign and malignant lesions

et al. 2006

View full text Add to dashboard Cite

The purpose of this study was to assess the reliability of MR imaging features in distinguishing between benign and malignant soft tissue masses that have a "cyst-like" appearance (hypointense to muscle on T1-weighted and hyperintense on T2-weighted or fluid-sensitive MR sequences). MR imaging features of 40 patients with histologically proven soft tissue masses (27 benign and 13 malignant lesions) that were hypointense to muscle on T1-weighted and hyperintense on T2-weighted or fluid-sensitive MR sequences were analysed to see if a distinction could be made between benign and malignant lesions. There were 23 females and 17 males (mean age, 56 years; age range, 23-82 years). MR imaging features analysed for statistical significance included lesion size, lesion homogeneity, presence of lobulation, depth in relation to fascia and border definition. Clinical assessment included the age and sex of the patient and location of the lesion. Statistically significant MR imaging features favouring a diagnosis of a malignant lesion included larger average dimension of the mass (P < or = 0.004), larger greatest dimension of the mass (P < or = 0.028) and heterogeneity of the lesion on T1-weighted sequences (P = 0.017). The most statistically significant predictor of malignancy was the larger average dimension of the mass.

show abstract

Section: Discussionmentioning

confidence: 94%

Soft tissue masses with “cyst-like” appearance on MR imaging: distinction of benign and malignant lesions

et al. 2006

View full text Add to dashboard Cite

show abstract

“…Different radiographic techniques have been used to evaluate ganglion cysts and their possible joint connections at this anatomic location (Schwimmer et al, 1985;Lee et al, 1987;Burk et al, 1988;Janzen et al, 1994;Artico et al, 1997;Kim et al, 2004;McCarthy and McNally, 2004). Ultrasound (Prevot et al, 1990;Leitjen et al, 1992;Lang et al, 1994;Dubuisson and Stevenaert, 1996;Aulisa et al, 1998) and CT (Firooznia et al, 1983;Pazzaglia, et al, 1989;Gambari et al, 1990;Antonini et al, 1991) have both been used in an attempt to characterize these cysts and their origins but have fallen short when compared to optimized MRI techniques and the superior soft-tissue contrast and high spatial resolution (Leon and Marano, 1987;Coakley et al, 1995;Kuntz et al, 1996;Uetani et al, 1998;Grant et al, 2004).…”

Section: Discussionmentioning

confidence: 99%

Application of three-dimensional rendering in joint-related ganglion cysts

2006

View full text Add to dashboard Cite

The origin of para-articular cysts is poorly understood and controversial. The relatively common, simple (extraneural) cysts are presumed to be derived from joints, although joint connections are not always established. Rarer complex cysts are thought by many to form de novo within nerves (intraneural ganglion cysts) or within vessels (adventitial cysts) (degenerative theory). We believe that these simple and complex ganglion cysts are joint-related (articular theory). Joint connections are often not readily appreciated with routine imaging or at surgery. Not identifying and/or treating joint connections frequently leads to cyst recurrence. More sophisticated imaging may enhance visualization of these joint connections. We created a 3D rendering technique to assess potential joint connections of simple and complex cysts localized to the knee and superior tibiofibular joints in patients with fibular (peroneal) neuropathy. Two- and three-dimensional data sets from MRI examinations were segmented semiautomatically by signal intensity with further refinement based on interaction with the user to identify specific anatomic structures, such as small nerves and vessels on serial images. The bone, cysts, nerves, and vessels were each assigned different color representations, and 3D renderings were created in ANALYZE using the data sets closest to isotropic (voxel with equal length in all dimensions) resolution as the primary background rendering. We selected four cases to illustrate the spectrum of pathology. In all of these cases, we demonstrated joint connections and correlated imaging and operative findings. Surgery addressing the cyst and the joint connection resulted in excellent outcomes; postoperative MRIs done more than 6 months later confirmed that there was no recurrence. In addition to highlighting the important relationship of these cysts to neighboring anatomic structures, this 3D technique allows visualization of "occult" connections not readily appreciated with standard MR imaging. We believe that these joint-related cysts have a common pathogenesis; they dissect through a capsular rent and follow the path of least resistance; they may form simple cysts by dissecting out into the soft tissue, or more complex cysts by dissecting within the epineurium of nerves or adventitia of vessels (along an articular branch), or various combinations of all of these types of cysts. Understanding the pathogenesis for cyst formation will improve surgical management and outcomes. We have adapted this 3D technique to enhance the visualization of cysts occurring at other joints.

show abstract

“…14 Intramuscular ganglion cysts are uncommon with only a few reported cases. 3,[5][6][7][8]15,16 Intramuscular ganglion cysts not connected to a joint are even rarer with few case reports involving the biceps brachialis and the thenar eminence muscles and the quadriceps, semimembranosus, and gastrocnemius muscles.…”

Section: -13mentioning

confidence: 98%

Ruptured intramuscular ganglion cyst in the gastrocnemius medialis muscle: Sonographic appearance

Park

Jin

Chun

et al. 2009

J of Clinical Ultrasound

View full text Add to dashboard Cite

We report the case of a 55-year-old woman who presented with a severe pain and a mass in the proximal portion of the medial calf. On sonography, the lesion appeared as a poorly defined hypoechoic lesion with interspersed muscle bundles. A total excision of the lesion was performed. On microscopic examination, the specimen demonstrated cystic lesions surrounded by fibrous walls within the muscle bundles. A ruptured intramuscular ganglion cyst diagnosis was made based on the histopathologic findings.

show abstract

Extra-articular soft tissue ganglion cyst around the knee: focus on the associated findings

Cited by 46 publications

References 19 publications

Soft tissue masses with “cyst-like” appearance on MR imaging: distinction of benign and malignant lesions

Soft tissue masses with “cyst-like” appearance on MR imaging: distinction of benign and malignant lesions

Application of three-dimensional rendering in joint-related ganglion cysts

Ruptured intramuscular ganglion cyst in the gastrocnemius medialis muscle: Sonographic appearance

Contact Info

Product

Resources

About