Bilateral lipoma arborescens: a rare case report
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Mohammed A Alamro1, Faisal A Al-Qifari2, Abdullah A Aldhibab1
1Department of Orthopedic Surgery, Prince Sultan Military Medical City, Riyadh, Saudi Arabia.
Introduction And Importance:
Lipoma arborescens (LA) is an extremely rare, benign, intra-articular condition characterized by the proliferation of mature adipocytes within the joint synovium. Most commonly, it presents as an unusual cause of intermittent knee pain and joint effusion. It most often affects the knee unilaterally, but bilateral involvement is exceptional; at least 10 cases have been reported in the literature.
Presentation Of The Case:
This study reports the case of a 27-year-old male patient who presented with pain and swelling in both knees. Magnetic resonance imaging of the knees demonstrated moderate joint effusions and diffuse intra-articular synovial villo-nodular proliferations.
Clinical Discussion:
The diagnosis of LA was confirmed by synovial biopsy, and a complete arthroscopic synovectomy was performed on both knees, resulting in marked symptomatic improvement and functional recovery at 6-month follow-up.
Conclusion:
This case highlights the exceptional occurrence of bilateral primary LA in a young adult and reinforces the effectiveness of arthroscopic synovectomy as a minimally invasive, curative option. It underscores the need for clinicians to consider bilateral disease in patients presenting with persistent, non-inflammatory knee effusions.