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Case Reports: Unusual presentation of more common disease/injury
Arthroscopic treatment for intra-articular fibroma of the tendon sheath in a teenager
  1. Justin Leal1,
  2. Paul Rizk1,2,
  3. Elham Nasri3 and
  4. Ryan Paul Roach1,2
  1. 1Department of Orthopaedic Surgery and Sports Medicine, University of Florida College of Medicine, Gainesville, Florida, USA
  2. 2Department of Orthopaedic Surgery and Sports Medicine, University of Florida Health, Gainesville, Florida, USA
  3. 3Department of Pathology, Immunology and Laboratory Health, University of Florida Health, Gainesville, Florida, USA
  1. Correspondence to Mr Justin Leal; justin524{at}ufl.edu

Abstract

An adolescent female patient presented with atraumatic left knee pain and limited flexion. MRI demonstrated evidence of a soft tissue lesion abutting the posterior cruciate ligament. Differential diagnosis included pigmented villonodular synovitis (PVNS) and fibroma of the tendon sheath (FTS). Following arthroscopic biopsy, histopathological evaluation confirmed FTS. The tumour was then excised via an arthroscopic approach. This case report provides a unique example of FTS abutting the cruciate ligaments in an uncommonly young female patient. It highlights the importance of including benign processes, such as FTS, in the differential with more aggressive-type diagnoses like PVNS. Furthermore, this case exemplifies an appropriate surgical indication for FTS. Finally, it emphasises the importance of communication and collaboration among orthopaedic subspecialists in providing safe and effective arthroscopic treatment of this unique tumour presentation.

  • Orthopaedics
  • Paediatric oncology
  • Surgical oncology
  • Paediatric Surgery

https://doi.org/10.1136/bcr-2022-248887

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    Footnotes

    • Contributors JL (formal analysis; writing—original draft; writing—review and editing); PR (supervision; writing—review and editing); EN (methodology; visualisation); RPR (conceptualisation; investigation; methodology; project administration; supervision; validation; writing—review and editing).

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.