Abstract
Purpose
We report on a group of patients with tumours in the Hoffa’s fat pad (HFP), their clinical presentation, histological type and treatment, including two synovial sarcomas with their clinical follow-up, which have not been described previously in the literature.
Methods
We performed a retrospective review of our prospectively collected database of 25 cases of HFP tumours with at least six months follow-up.
Results
The gender, age at presentation (over and under 16 years of age), clinical features, history of trauma, treatment chosen, and complications were recorded. The mean age of the patients was 32 years (three to 47). Six patients were under 16 years old. Pain was the most common symptom, present in 92 % (n = 23/25). The final diagnoses included 23 (92 %) benign tumours and two (8 %) malignant tumours. The most common benign tumour was pigmented villonodular synovitis (PVNS) (48 % n = 12). The two malignant tumours were synovial sarcomas and both presented in patients under 16 years old.
Conclusions
Hoffa’s fat pad tumours are an uncommon and rarely diagnosed group of lesions that can be misinterpreted as any knee pathology. Although the majority of HFP tumours are benign, malignant tumours should be considered in the differential diagnosis for the paediatric population.
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References
Khon D, Deiler S, Rudert M (1995) Arterial blood supply of the infrapatellar fat pad. Anatomy and clinical consequences. Arch Orthop Trauma Surg 114:72–75
Gallagher J, Tierney P, Murray P, O’Brien M (2005) The infrapatellar fat pad: anatomy and clinical correlations. Knee Surg Sports Traumatol Arthrosc 13:268–272
Helpert C, Davies AM, Evans N, Grimer RJ (2004) Differential diagnosis of tumours and tumour-like lesions of the infrapatellar (Hoffa’s) fat pad: pictorial review with an emphasis on MR imaging. Eur Radiol 14(12):2337–2346
Muscolo DL, Ayerza MA, Makino A, Costa-Paz M, Aponte-Tinao LA (2003) Tumors about the knee misdiagnosed as athletic injuries. J Bone Joint Surg Am 85-A(7):1209–1214
Dean BJF, Reed DW, Matthews JJ, Pandit H, McNally E, Athanasou NA, Gibbons CLMH (2011) The management of solitary tumours of Hoffa’s fat pad. Knee 18:67–70
Stacy GS, Heck RK, Peabody TD, Dixon LB (2002) Neoplastic and tumorlike lesions detected on MR imaging of the knee in patients with suspected internal derangement. Part 2, articular and juxtaarticular entities. AJR Am J Roentgenol 178:595–599
Gebhardt MC, Parekh SG, Rosenberg AE, Rosenthal DI (1999) Extraskeletal myxoid chondrosarcoma of the knee. Skeletal Radiol 28:354–358
Magi M, Branca A, Bucca C, Langerame U (1991) Hoffa’s disease. Ital J Orthop Traumatol 17:211–216
Mohamed-Ali V, Pinkney JH, Coppack SW (1998) Adipose tissue as an endocrine and paracrine organ. Int J Obes Relat Metab Disord 22:1145–1158
Mine T, Ihara K, Tanaka H, Taguchi T, Azuma E, Tanigawa Y (2003) A giant ganglion cyst that developed in the infrapatellar fat and partly extended into the knee joint. Arthroscopy 19:E40
Palumbo RC, Matthews LS, Reuben JM (1994) Localized pigmented villonodular synovitis of the patellar fat pad: a report of two cases. Arthroscopy 10(4):400–403
Sakai H, Tamai K, Iwamoto A, Saotome K (1999) Para-articular chondroma and osteochondroma of the infrapatellar fat pad: a report of three cases. Int Orthop 23(2):114–117
Ingabire MI, Deprez FC, Bodart A, Puttemans T (2012) Soft tissue chondroma of Hoffa’s fat pad. JBR-BTR 95(1):15–17
Teo EHJ, Strouse PJ, Hernandez RJ (2000) MR imaging differentiation of soft-tissue hemangiomas from malignant soft-tissue masses. AJR Am J Roentgenol 174:1623–1628
Chandrasekar CR, Wafa H, Grimer RJ, Carter SR, Tillman RM, Abudu A (2008) The effect of an unplanned excision of a soft-tissue sarcoma on prognosis. J Bone Joint Surg Br 90(2):203–208
Ayerza MA, Abalo E, Aponte-Tinao L, Muscolo DL (2007) Endoscopic resection of symptomatic osteochondroma of the distal femur. Clin Orthop Relat Res 459:150–153
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Albergo, J.I., Gaston, C.L.L., Davies, M. et al. Hoffa’s fat pad tumours: What do we know about them?. International Orthopaedics (SICOT) 37, 2225–2229 (2013). https://doi.org/10.1007/s00264-013-2041-z
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DOI: https://doi.org/10.1007/s00264-013-2041-z