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Intravascular Papillary Endothelial Hyperplasia (Masson's Tumor) Involving the Knee Synovium
Ippokratis Pountos1, Asim Siddiqui2
1Department of Trauma and Orthopaedics, University of Leeds, UK.
Insights
Intravascular papillary endothelial hyperplasia (Masson's tumor) is a rare benign vascular lesion. Embolization of the tumor's blood supply offers a viable alternative to surgery for knee joint involvement.
Area of Science:
- Vascular pathology
- Orthopedic oncology
- Diagnostic challenges in rheumatology
Background:
- Intravascular papillary endothelial hyperplasia (Masson's tumor) is a rare benign vascular lesion.
- Characterized by abnormal endothelial cell proliferation.
Observation:
- A case of Masson's tumor in the knee joint of a woman presenting with recurrent pain and effusion.
- Symptoms began 5 years prior after minor trauma.
- Arthroscopic biopsies during asymptomatic periods were normal.
Findings:
- Surgical excision led to recurrence after 2 years.
- Successful treatment was achieved through embolization of the tumor's vascular supply.
Implications:
- Masson's tumor of the synovium is uncommon and diagnostically challenging.
- Embolization is a viable alternative to resection for preventing recurrence.
- Highlights the importance of considering vascular lesions in unexplained joint pain.
Introduction:
Intravascular papillary endothelial hyperplasia or Masson's tumor is a rare benign lesion of vascular origin characterized by abnormal proliferation of endothelial cells.
Case Report:
We present a case of this lesion involving the knee joint of a Caucasian woman who was referred to our institution for the evaluation of recurrent right knee pain. Her symptoms have started insidiously 5 years earlier following minor trauma. Recurrent symptomatic knee effusion was the cardinal symptom. Following the surgical excision of the lesion, recurrence occurred 2 years later. The tumor was successfully treated with embolization of its vascular supply.
Conclusion:
Masson's tumor involving the synovium is an uncommon condition. The intermittent symptomatology and normal appearance of biopsies taken arthroscopically during asymptomatic periods can make the diagnosis challenging. Although resection is proposed to prevent recurrence, embolization of the vascular supply of the tumor can be a viable alternative.