Synovial hemangioma: A rare benign synovial lesion

Rajni, .; Khanna, Geetika; Gupta, Anu; Gupta, Vikas

doi:10.4103/0377-4929.41676

Cited by 8 publications

(4 citation statements)

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“…Pain is typically in the anterior aspect of the knee but can be posterior ( 14 ) or diffuse. Swelling, tenderness, effusion ( 5 , 9 – 11 , 17 , 21 , 23 , 26 , 30 , 33 , 34 , 44 , 49 , 50 , 55 ) and haemarthrosis ( 5 , 9 , 11 , 12 , 18 , 22 , 30 , 31 , 37 , 39 , 41 , 46 , 50 , 54 , 55 , 57 , 59 ) are frequent and can be recurrent. Occasionally, a palpable soft tissue mass ( 3 , 4 , 10 , 44 , 46 , 55 , 61 ) can be noted.…”

Section: Discussionmentioning

confidence: 99%

“…Anterior masses are more evident in complete flexion of the knee ( 3 , 21 , 44 ) and can be compressible, refilling when pressure is released ( 21 ). Limitation of motion ( 3 , 5 , 8 – 10 , 12 , 17 , 25 , 28 , 33 , 37 , 38 , 46 , 61 ) and mild muscular atrophy ( 5 , 11 , 33 , 34 , 36 , 49 , 55 ) can be present. Joint locking is infrequent but has been described when synovial haemangioma is located in the intercondylar notch ( 22 , 47 ) or in the suprapatellar pouch ( 6 ).…”

Section: Discussionmentioning

confidence: 99%

“…Once a benign synovial lesion is suspected, it is unsettled if a biopsy is needed or if excisional biopsy and regional synovectomy with histological examination can confirm the diagnosis and simultaneously accomplish definitive treatment. Whether open ( 2 – 5 , 8 – 10 , 16 , 21 , 37 , 38 , 57 ) surgery is preferable to arthroscopic ( 6 , 38 , 39 ) surgery remains controversial, especially in localized intra-articular lesions. There is no clear information on the recurrence rate after surgical treatment.…”

Section: Introductionmentioning

confidence: 99%

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Location, Clinical Presentation, Diagnostic Algorithm and Open vs. Arthroscopic Surgery of Knee Synovial Haemangioma: A Report of Four Cases and a Literature Review

et al. 2021

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Objective: The aim was to report 4 patients with intra-articular knee synovial haemangioma (KSH) and to perform a systematic review to describe the patient characteristics, patterns of tumor location, clinical presentation, usefulness of imaging examinations, pros and cons of arthroscopic vs. open resection, and follow-up in the literature.Design: From 1996 to 2016, four patients with KSH were retrospectively reviewed. A literature search was conducted in PubMed from 2000/01 to 2020/06 using the search terms “synovial haemangioma” and “knee.” Fifty full-text articles that included a total of 92 patients were included for further discussion.Results: Four adults (20–40 years) were diagnosed with KSH. Three lesions located in the suprapatellar pouch, two eroding the patella and one the supratrochlear bone, and one in the posterior compartment. Persistent anterior knee pain was the main complain. MRI revealed a benign tumor mass in all cases except one. Open excisional biopsy and regional synovectomy were performed in three patients, and by arthroscopy of the posterior compartment in the fourth. Histological type was arteriovenous in three cases and capillary in one. A pain-free knee without recurrence was achieve in all cases except one, which was successfully reoperated. Average follow-up time was 3.5 years. A literature review showed that KSH appears most frequently in children and teenagers (64.6%) and does not differ by gender. The suprapatellar and patella-femoral joint compartment was the most frequent location (47.9%). The bony tissue of the knee was rarely affected (13.5%). Pain, swelling and haemarthrosis were frequently reported (88.2, 66.7, and 47.1%). MRI was the most commonly used imaging test (98%). Treatment consisted of regional synovectomy by open surgery or arthroscopy in 66.7 and 15.6% of cases, respectively.Conclusions: KSH should be considered in the differential diagnosis of adult patients with chronic low-intensity knee pain. MRI is the most useful exam because it establishes the location, extent and benign characteristics of the tumor. Definitive diagnosis requires histological examination. We believe excisional biopsy and regional synovectomy by arthroscopy should be the treatments of choice for intra-articular tumors, but we recommend open surgery when the lesion extends to the tendons, muscle or bone.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Location, Clinical Presentation, Diagnostic Algorithm and Open vs. Arthroscopic Surgery of Knee Synovial Haemangioma: A Report of Four Cases and a Literature Review

et al. 2021

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“…The management of IPEH/MH depends on the tumor size, extent, behavior, resectability, and the functional need of the individual [ 25 , 26 ]. They range from intrasynovial instillation of sclerosing agents (sodium tetradecyl sulfate [3% sterol], sodium morrhuate, monoethanolamine oleate, and sodium psylliate) [ 27 ], holmium ablation [ 28 ], Nd:YAG laser [ 29 ], cauterization [ 30 ], freezing [ 30 ], radiotherapy, embolization [ 30 ], and open or arthroscopic synovectomy [ 31 , 32 ].…”

Section: Discussionmentioning

confidence: 99%

Masson’s Hemangioma of Knee: A Rare Case Report

Ranjan¹,

Kumar²,

Jeyaraman³

et al. 2021

JOCR

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Introduction: Intrasynovial hemangioma, a rare benign vascular lesion of joint cavities, is also called intrasynovial papillary endothelial hyperplasia or Masson’s hemangioma (MH). These lesions are characterized by abnormal proliferation of endothelial cells with mild atypia with an organized thrombus. MH follows an individualized protocol for its management. Case Report: A 22-year-old male gave a 10-year history of the diagnosed and operated (arthroscopically) case of synovial hemangioma of the left knee and presented with similar complaints. There was no history of trauma or infection over the left knee. The movements of the left knee were normal except with terminal restriction of movements. MRI of the left knee suggested intrasynovial low flow vascular malformation within the substance of the synovium. The patient underwent synovectomy of the hemangiomatous lesion in toto without any recurrence in the follow-up period for 8 months. Histopathology confirmed the diagnosis of intravascular papillary endothelial hyperplasia/MH. Conclusion: Although intrasynovial hemangioma is a very rare clinical entity, Orthopedic surgeons should have a high index of suspicion for MH, when a long-standing pain and hemarthrosis of the knee joint is being encountered in the clinical practice. Keywords: Hemangioma, Intrasynovial, MRI, Excision biopsy.

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