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Bilateral solid parameniscal masses in the knees.

Tsutomu Akahane¹, Ken'ichi Isobe, Tominaga Shimizu

¹Department of Orthopedic Surgery, Shinshu University School of Medicine, Matsumoto, Japan.

Arthroscopy : the Journal of Arthroscopic & Related Surgery : Official Publication of the Arthroscopy Association of North America and the International Arthroscopy Association

|December 16, 2003

Summary

This study describes rare, bilateral knee masses in an elderly woman, initially resembling parameniscal cysts. These unusual masses were found to be degenerated cysts associated with severe osteoarthritis and meniscal degeneration.

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Area of Science:

Orthopedic Surgery
Knee Joint Pathology

Background:

Parameniscal cysts are typically minor lesions linked to meniscal tears.
Their presentation is usually asymptomatic and localized.

Observation:

An 80-year-old woman presented with bilateral medial soft tissue knee masses.
Imaging and arthroscopy revealed no meniscal tears, despite the masses' resemblance to parameniscal cysts.
Surgical excision was performed due to the size and nature of the masses.

Findings:

Histological examination revealed solid masses with a capsular layer containing fibrin, granulation tissue, and fibrous meniscal fragments.
These findings suggest a chronic degenerative process rather than acute cystic lesions.

Implications:

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The case suggests that "ancient" or "senescent" parameniscal cysts, resulting from long-term degeneration, can occur.
Such degenerated cysts may be associated with severe osteoarthritis and underlying meniscal degeneration, even without apparent meniscal tears.