Morel-Lavallée lesion in a ‘non-traumatic’ thigh: a diagnostic challenge!

Balaji Jayasankar,Devesh Sanjeev Ballal,Gabriel Rodrigues,Ranjini Kudva

doi:10.3329/bjms.v18i1.39566

Abstract

Background: Morel-Lavallée Lesion (MLL) or Morel-Lavallée Seroma (MLS) is a posttraumatic seroma that occurs following a closed degloving injury. It is very important for trauma surgeons to be aware of this relatively rarely reported entity as early diagnosis increases the likelihood of successful management. Case report: We present a patient, wherein the patient had no history of trivial trauma and presented with a gradually growing swelling of left thigh, that was clinically and radiologically diagnosed as a soft tissue neoplasm, successfully managed by surgical excision and were reported to be a MLS. The clinical diagnostic dilemma was solved by the histopathologist! Conclusion: A differential diagnosis of MLL should be kept in mind in patients presenting with soft tissue swellings. Bangladesh Journal of Medical Science Vol.18(1) 2019 p.145-148

Highlights

Morel-Lavallée Seroma (MLS) was first described in 1863 by the French surgeon Victor Auguste Francois Morel-Lavallée as fluid collections dissecting fatty tissues[1].This term has expanded to encompass any closed degloving injury causing persistent fluid collection
MLS was first described in 1863 by the French surgeon Victor Auguste Francois Morel-Lavallée as fluid collections dissecting fatty tissues[1].This term has expanded to encompass any closed degloving injury causing persistent fluid collection. Though these lesions can occur anywhere, they are common in the proximal thigh and in the trochanteric region[2].Though MLS are most common after violent tangential trauma such as road traffic accidents (RTA), usually in association with pelvic/ acetabular fractures, they have been reported after surgical procedures such as abdominoplasty and in a few cases, the patient does not recall the occurrence of trauma, as in our case[3].The shearing forces due to trauma cause the mobile skin and subcutaneous tissue to avulse from the relatively fixed aponeurotic fascia
Various diagnostic modalities are in vogue, of which Magnetic Resonance Imaging (MRI) seems to be the best[5]

Summary

Introduction

MLS was first described in 1863 by the French surgeon Victor Auguste Francois Morel-Lavallée as fluid collections dissecting fatty tissues[1].This term has expanded to encompass any closed degloving injury causing persistent fluid collection. Though these lesions can occur anywhere, they are common in the proximal thigh and in the trochanteric region[2].Though MLS are most common after violent tangential trauma such as road traffic accidents (RTA), usually in association with pelvic/ acetabular fractures, they have been reported after surgical procedures such as abdominoplasty and in a few cases, the patient does not recall the occurrence of trauma, as in our case[3].The shearing forces due to trauma cause the mobile skin and subcutaneous tissue to avulse from the relatively fixed aponeurotic fascia.

Results

Conclusion