Large infrapatellar ganglionic cyst of the knee fat pad: a case report and review of the literature

Ioannis Nikolopoulos,Stephanos Kalos,Andreas Giannakopoulos,Apostolos Ilias,Dimitris Kipriadis,George Krinas

doi:10.1186/1752-1947-5-351

Ioannis Nikolopoulos, Stephanos Kalos + Show 4 more

Open Access

https://doi.org/10.1186/1752-1947-5-351

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Abstract

IntroductionLarge ganglionic cystic formations arising from the infrapatellar fat pad are quite uncommon and only a few are mentioned in the literature. An open excision in these cases is mandatory.Case presentationWe report the case of a large infrapatellar fat pad ganglion in a 37-year-old Greek man with chronic knee discomfort. The ganglionic cyst originated from the infrapatellar fat pad and had no intrasynovial extension. The final diagnosis was determined with magnetic resonance imaging of the knee, and the lesion was treated with surgery.ConclusionsThese lesions are asymptomatic in most cases but often are misdiagnosed as meniscal or ligamentous lesions of the knee joint. Nowadays, the therapeutic trend for such lesions is arthroscopic excision, but when there is a large ganglion, as in this case report, the treatment should be an open and thorough resection. This report is intended mostly but not exclusively for clinical physicians and radiologists.

Highlights

Large ganglionic cystic formations arising from the infrapatellar fat pad are quite uncommon and only a few are mentioned in the literature
Case presentation We report the case of a 37-year-old Greek man who was seen in our outpatient clinic and who had anterior left knee pain that lasted more than five months
Our case regards a large intra-articular extrasynovial ganglion cyst and this is the reason we believe that arthroscopic intervention cannot provide a complete resection of the cyst

Summary

Conclusions

Our case regards a large intra-articular extrasynovial ganglion cyst and this is the reason we believe that arthroscopic intervention cannot provide a complete resection of the cyst. In such cases, the possibility of leaving even a small piece of wall lining poses a high potential risk of recurrence. MRI helps in treatment decision making, as was demonstrated in our case, in which the ganglionic cyst was Figure 5 (A) Cystic mass and incision site, (B) surgical approach and lesion exposure, and (C) synovium invasion and capsule defect after lesion excision. We consider that open surgical excision should be reserved for cases of large ganglionic cysts because it can provide a complete resection of the lesion and minimize the risk of recurrence.

Introduction

Discussion

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