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An Extra-articular Ganglion Cyst with Multiple Fluid-Fluid Levels
Semra Duran1, Cem Cuneyt Kose2, Servet Guresci3
1Ankara City Hospital, Radiology, Ankara, Turkey.
Current Medical Imaging
|August 9, 2023
Summary
Ganglion cysts, typically benign knee tumors, can present with unexpected fluid-fluid levels on MRI. This case highlights hemorrhage within a ganglion cyst, expanding differential diagnoses for such findings.
Area of Science:
- Orthopedic Surgery
- Radiology
- Pathology
Background:
- Ganglion cysts are common benign soft tissue tumors of the knee.
- Magnetic resonance imaging (MRI) typically shows them as multiloculated fluid collections.
- Fluid-fluid levels are not an expected finding in typical ganglion cysts.
Observation:
- A 36-year-old female presented with right knee swelling.
- MRI revealed a multiseptated cyst with multiple fluid-fluid levels anterior to the patellar tendon.
- Surgical excision and histopathology confirmed a ganglion cyst with hemorrhage.
Findings:
- The presence of hemorrhage can alter the imaging appearance of ganglion cysts.
- Fluid-fluid levels in knee lesions may indicate diagnoses beyond typical ganglion cysts.
- Histopathology is crucial for definitive diagnosis.
Implications:
- Ganglion cysts should be included in the differential diagnosis for knee lesions exhibiting fluid-fluid levels on MRI.
- Consideration should be given to other differentials such as hemangioma, synovial sarcoma, and aneurysmal bone cysts.
- Accurate diagnosis impacts appropriate treatment and patient management.
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