Giant Baker Cyst Extending Up to the Gastrocnemius: A Case Report

Area of Science:

• Rheumatology
• Orthopedic Surgery
• Radiology

Background:

• Baker cysts are abnormal fluid collections in the gastrocnemius-semimembranous bursa, often associated with intra-articular pathology.
• Giant Baker cysts, particularly those with intramuscular extension, are exceptionally rare in clinical literature.
• Rheumatoid arthritis is a known predisposing factor for Baker cyst development, but massive cysts are uncommon.

Purpose of the Study:

• To document a rare case of a giant Baker cyst in a patient with rheumatoid arthritis.
• To describe the diagnostic imaging findings and surgical management of this large cyst.
• To highlight the rarity of such massive cysts in the context of rheumatoid arthritis.

Main Methods:

• A case report detailing a female patient with rheumatoid arthritis presenting with a giant Baker cyst.
• Diagnostic imaging utilizing Magnetic Resonance Imaging (MRI) to characterize the cyst's size, location, and extent.
• Surgical intervention involving open excision of the Baker cyst.

Main Results:

• MRI revealed a complex, multiloculated giant Baker cyst measuring 11.8 cm x 4.6 cm x 3.3 cm, originating from the left knee.
• The cyst demonstrated a significant intermuscular extension, a rare finding in reported cases.
• Successful surgical excision was performed, with no evidence of recurrence after one year of follow-up.

Conclusions:

• Giant Baker cysts, even in the setting of rheumatoid arthritis, are amenable to surgical treatment.
• The significant size and intramuscular extension in this case underscore its rarity.
• This case contributes to the literature on large Baker cysts and their management in rheumatic disease patients.