樹枝狀脂肪瘤症為罕見膝關節疾病,主要病變在滑囊膜內絨毛狀成熟脂肪組織大量增生。疾病的發生常伴隨外傷性或退化性關節病變。本文所述病例是一個年青的男性運動員, 因外傷後造成右膝關節的腫痛及關節運動受限制來院求診, 臨床上檢查除疼痛性腫塊外,亦發現相鄰關節活動度限制,放射學上磁振造影掃瞄提供快術正確的術前診斷,發現此典型樹枝狀脂肪組織侵潤右側髕骨上凹陷部。病患接受外科手術切除腫瘤,病理確定為樹枝狀脂肪瘤。手術後利用CPM復健關節活動度,手術後五個星期因膝關節運動限制,而再住院復健關節活動功能。術後三個月追蹤發現,病患可毫無障礙從事以前的運動。
Lipoma arborescens is a rare, benign polypoid fatty synovial proliferation of the joints which is associated with trauma and degenerative joint disease. We present one patient who had been suffering from swelling and painful motion of the right knee during exercise for half a year. Physical examinations revealed a palpable mass over the suprapatellar pouch of the right knee measuring about 15cm * 10 cm. Plain radiology showed soft tissue swelling of the suprapatellar pouch and magnetic resonance imaging of the right knee revealed a fatty frond-like synovial proliferation over the suprapatellar pouch. The patient received an arthrotomy and a synovectomy. Speciesmen was applied to the pathological study. Gross examination of the lesion revealed a yellowish villous proliferation. Histological examination revealed diffuse replacement of the subsynoviallayer by mature adipose tissue which formed villousnodular projections. After the operation, none of the patient's previous symptoms remained, although some stiffness associated with flexion contracture were found during the 5th-week of follow-up. The patient remained asymptomatic with a full range of motion and good quadricep strength three months after treatment.