Cavernous Hemangioma of Hoffa's Fat Pad: A Rare Case Presentation

Cavernous hemangiomas are benign vascular malformations composed of dilated, blood-filled channels, commonly occurring in cutaneous or subcutaneous tissues of the head, neck, or trunk. Their occurrence in the knee joint, particularly within Hoffa's (infrapatellar) fat pad, is extremely rare. Patients usually present with chronic anterior knee pain, swelling, and sometimes mechanical symptoms. Due to the wide range of differential diagnoses for knee swellings, diagnosis is often delayed without appropriate imaging. Magnetic resonance imaging (MRI) is pivotal for accurate localization, lesion characterization, and pre-operative planning, while complete surgical excision remains the treatment of choice.

We present the case of a 35-year-old female with a 3-year history of persistent anterior knee pain and swelling. Clinical suspicion was broad, and MRI was performed, which revealed a well-defined cavernous hemangioma confined to the infrapatellar fat pad. The patient underwent en bloc surgical excision, which was completed successfully without complications. Postoperatively, she achieved complete symptomatic relief and regained normal knee function. Histopathological examination confirmed the diagnosis of cavernous hemangioma.

This case emphasizes the rarity of Hoffa's fat pad cavernous hemangiomas, the diagnostic challenges they pose, and the value of MRI in establishing an accurate pre-operative diagnosis. Complete surgical excision provides excellent outcomes by relieving symptoms, preventing recurrence, and restoring knee function.