[Gigantic prepatellar "tumor" in rheumatoid arthritis-a case report]
B Artzt1, M Arndt2, B Wickler2
1Klinik für Orthopädie und Unfallchirurgie, AGAPLESION MARKUS KRANKENHAUS, Wilhelm-Epstein-Str. 4, 60431, Frankfurt am Main, Deutschland. Boris.Artzt@fdk.info.
Zeitschrift Fur Rheumatologie
|May 1, 2021
Summary
Differentiating soft tissue tumors is crucial. This case highlights how a massive knee swelling in a rheumatoid arthritis patient was diagnosed as benign bursitis after extensive workup, emphasizing the need for a clear diagnostic approach.
Area of Science:
- Orthopedic Surgery
- Rheumatology
- Musculoskeletal Oncology
Background:
- Differentiating benign from malignant soft tissue tumors in extremities is critical due to heterogeneity and low malignancy incidence.
- A reproducible diagnostic and therapeutic concept is needed for extremity tumors, encompassing benign changes, sarcomas, and pseudotumors.
Observation:
- A 59-year-old patient with rheumatoid arthritis presented with a slow-growing, massive prepatellar swelling over 5 years.
- A comprehensive diagnostic process including imaging (X-ray, MRI) and clinical evaluation ruled out malignancy.
Findings:
- Histopathology confirmed the swelling as massive prepatellar bursitis, initially suspected to be malignant.
- Surgical excision was performed according to tumor surgery recommendations.
Implications:
- This case underscores the importance of a structured diagnostic approach for unexplained musculoskeletal swellings, especially in patients with inflammatory conditions.
- Periarticular swellings in rheumatic diseases can have benign causes like organized bursitis, necessitating careful differential diagnosis.
Keywords:
Benign soft tissue tumorsMalignant soft tissue tumorsPrepatellar bursitisPseudotumorsSoft tissue sarcomas
