Dizde Ağrısız, Kronik Effüzyonun Önemli ve Az Karşılaşılan Bir Sebebi: Lipoma Arboresans / A Significant and Rare Cause of Painless Chronic Effusion in the Knee: Lipoma Arboresans

Ozet Lipoma Arboresans, nadiren karsilasilan intra-artikuler bir lezyon olup etyolojisi bilinmemektedir. Genellikle dizde lokalizedir ve sinovyumda villoz lipomatoz proliferasyon ile karakterizedir. Belirtiler yavas yavas ilerleyen sislik, zaman zaman effuzyon ile beraber agrilarda artis, eklem hareketinde kisitlilik seklindedir. Manyetik rezonans goruntuleme erken tani icin onemli bir tekniktir. Lipom Arboresan, kronik eklem efuzyonlu hastalarin ayirici tanisinda dusunulmelidir. Burada bildirilen 2 olgu, 7 yildir zaman zaman sag dizde agrisiz sismesi olan 42 yasinda erkek hasta ve 4 yildir zaman zaman dizde sisme ve agrisi olan 46 yasinda erkek hastadir. Birinci hastanin eklem hareketinde belirgin kisitlilik varken, ikinci hastanin eklem hareketindeki kisitlilik daha azdir. Her iki hastada da uzun suren semptomlara ragmen kemik erozyonu veya dejeneratif degisiklikler saptanmadi. Manyetik rezonans goruntuleme, suprapatellar ve retropatellar bolgede multipl villoz lipotomoz sinoviyal proliferasyonu gosteren lezyon ve eklem efuzyonunu belirledi. Her iki hastada da kitle artrotomik sinovektomi ile eksize edildi. Lipom Arboresan tanisi patoloji ile konmustur. Herhangi bir etyolojiye bagli olmayan uzun bir gecmise sahip agrisiz sinovit vakalarinda Lipoma Arboresan dusunulmelidir. Lipom Arboresan teshisi konan vakalarda, diger diz ve aslinda tum eklemler ayrica incelenmelidir. Manyetik rezonans goruntulemenin erken teshis ve tedavide oynadigi rolun onemi unutulmamalidir. Anahtar Kelimeler: Lipoma Arboresan, Villoz Lipomatoz Sinoviyal Proliferasyon, Diz eklemi, Magnetik Rezonans Goruntuleme, Yumusak Doku Neoplazisi Abstract Lipoma Arborescence is a rarely encountered intra-articular lesion of unknown etiology. It is generally characterised by villous lipotomous proliferation in the synovium and is typically localised in the knee. The symptoms are a slowly progressing swelling, variations in pain, limitation of joint movement and intermittent joint effusion. Magnetic resonance imaging is an important technique for early diagnosis. Lipoma Arborescence should be considered in the differential diagnosis of patients with chronic joint effusion. Two cases reported here are a 42-year-old male patient, who has painless swelling in the right knee for 7 years and a 46-year-old male patient, who has been suffering from knee swelling and pain for 4 years. While (delete) There is a significant limitation in the joint motion of the first patient whereas there is less restriction of the joint motion of the second patient. Bone erosion or degenerative changes were not detected in both patients despite prolonged symptoms. Magnetic resonance imaging determined a lesion demonstrating multiple villous lipotomous synovial proliferation in the suprapatellar and retropatellar area and effusion of the joint. The mass was excised by arthrotomic synovectomy in both patients. A diagnosis of Lipoma Arborescence was made by pathology. Lipoma Arboresan should be considered in cases of painless synovitis with a long history without any etiology. In case of Lipom Arboresan diagnosis, the other knee and indeed all joints should be examined separately. The role of magnetic resonance imaging in early diagnosis and treatment should not be forgotten. Keywords: Lipoma Arborescence, Villous Lipomatous Synovial Proliferation, Knee Joint, Magnetic Resonance Imaging, Soft Tissue Neoplasms.