From: Surgical management of upper limb lipoma arborescens: a systematic review
Study | Number of lesions | Location | Imaging studies | Procedure | Follow-up | Recurrence | Postoperative outcomes |
---|---|---|---|---|---|---|---|
Elamin et al. [36] | 1 | Shoulder (subacromial) | Xray: no | Arthroscopic excision | 60 | No | Full active ROM and normal RC strength |
MRI: supraspinatus tendinopathy with a partial tear. Soft tissue mass in the subacromial space measuring 2.5 × 1.0 × 0.5 cm | |||||||
Kawashima et al. [3] | 1 | Shoulder (subdeltoid) | Xray: normal | Arthroscopic synovectomy and RC repair | 9 | No | Occasional aching, good function |
MRI: subdeltoid fluid villous projections, full-thickness supraspinatus tear | |||||||
Paccaud and Cunningham [13] | 1 | Elbow (intraarticular) | Xray: no | Arthroscopic synovectomy and posterior humeroulnar decompression | 14 | No | Full ROM. Asymptomatic |
MRI: large intra-articular multilobulated pseudo-tumoral mass causing posterior humeroulnar impingement with mixed components including lipomatous and synovial fringes | |||||||
Lim et al. [35] | 1 | Shoulder (subacromial, subdeltoid) | Xray: bony spurs in the acromion and greater tuberosity | Arthroscopic bursectomy, lipoma excision, acromioplasty, and RC repair | 5 | No | Asymptomatic |
MRI: Partial-thickness bursal tear of the supraspinatus tendon, subacromial-subdeltoid bursa fluid-distended-fat like nodular projections, greater tuberosity, and lateral acromion osteophytes | |||||||
Beyth and Safran [2] | 1 | Shoulder (intraarticular) | Xray: Hill Sachs | Arthroscopic synovectomy and lipoma excision | 12 | No | Full ROM. Asymptomatic |
MRI: joint effusion and synovial hyperplasia | |||||||
Mohammad et al. [34] | 1 | Elbow (antecubital fossa) | Xray: reactive changes in the radial tuberosity | Open bicipitoradial bursectomy, lipoma excision, and biceps debridement | 6 | No | Occasional aching, no calcifications |
MRI: cystic swelling in the right bicipitoradial bursa with peripheral frond-like and ovoid fatty components. Thickening of the distal biceps tendon insertion and hypertrophy of the bicipital radial tuberosity with some associated edema and chronic bicipitoradial bursitis | |||||||
Kim et al. [33] | 1 | Shoulder (subdeltoid, subacromial) | Xray: multiple calcifications, enthesophyte at greater tuberosity | Open lipoma excision, lipoma arborescens excision, and arthroscopic posterior labrum repair | 36 | No | High satisfaction and no limitations |
MRI: paralabral cyst which extends into suprascapular and spinoglenoid notch after a posterior labral tear, SLAP, lipoma in front of the anterolateral cortex of the humeral head, encapsulated mass between infraspinatus and deltoid muscle, villous projections (lipoma arborescens) within the mass with osteochondral metaplasia | |||||||
Stepan et al. [14] | 1 | Wrist (dorsal-extensor retinaculum) | Xray: mass dorsal to the carpus, soft tissue, and fat attenuation | Open tenosynovectomy of the fourth dorsal compartment and fatty mass excision | 3 | No | Pain-free full shoulder function |
MRI: proliferative tenosynovitis distending the fourth dorsal compartment, containing extensive areas of thick, enhancing tenosynovium as well as macroscopic lobules of subsynovial fat encircling extensor digitorum communis and extensor indicis tendons | |||||||
White et al. [32] | 1 | Shoulder (bicipital groove) | Xray: normal | Open synovectomy, lipoma excision, tenodesis, diagnostic arthroscopy | 6 | No | Pain-free with full shoulder function and rotation |
MRI: frond-like tissue extending from the synovium, which followed the signal intensity of subcutaneous fat on all sequences. The synovium of the glenohumeral joint had no evidence of involvement by this process | |||||||
Benegas et al. [1] | 1 | Shoulder (intrarticular, subacromial) | Xray: increased soft tissue. Simple radiography did not show any abnormalities, except for increased soft-tissue volume | Arthroscopic and open synovectomy, lipoma excision, and RC repair | 4 | No | Asymptomatic |
MRI: full-thickness tear of the anterior portion of the supraspinatus tendon and significant glenohumeral and subacromial synovitis, with signs of fatty metaplasia | |||||||
Hill et al. [37] | 1 | Wrist (dorsal-extensor retinaculum) | Xray: dorsal soft-tissue mass-mild degenerative disease of the radioscaphoid joint | Open lipoma excisional biopsy | 2 | No | Significant improvement. Complication: minor postoperative cellulitis |
MRI: high signal intensity soft tissue lesion consistent with fat and multiple frond-like projections of similar intensity investing the extensor tendons | |||||||
Silva et al. [31] | 1 | Wrist (dorsal-extensor retinaculum, also in the knee and ankle) | Xray: soft tissue mass | Open excision | 48 | No | Asymptomatic |
Chae et al. [30] | 1 | Shoulder (intraarticular) | Xray: humeral head erosion | Open synovectomy and lipoma excision | 12 | No | Favorable outcome |
MRI: well-capsulated, mass-like projections were encircling the right glenohumeral joint and containing a villonodular fat component | |||||||
Mayayo Sinues et al. [29] | 1 | Elbow (antecubital fossa) | Xray: soft tissue mass | Open partial synovectomy | 48 | No | Full ROM |
MRI: circumscribed mass along the bicipitoradial bursa enveloped the biceps tendon, with a heterogeneous signal bursal effusion and fat tissue deposits similar to small polypoid lesions from the wall to the interior of the mass | |||||||
In et al. [28] | 1 | Shoulder (intraarticular) | Xray: osteopenia and arthritic changes | Arthroscopic synovectomy | 12 | No | Uneventful |
MRI: intra-articular frond-like or villous nodules of high signal intensity represent fat. Bone erosion was present at the superior aspect of the humerus | |||||||
Yildiz et al. [27] | 1 | Wrist (dorsal-extensor retinaculum) | Xray: soft tissue mass | Open excision | 24 | No | Asymptomatic |
Dinauer et al. [26] | 2 (asynchronous bilateral lesion) | Elbow (bicipitoradial bursa) | Xray: a) normal; b) soft tissue swelling | Open excisional biopsy | a) 46; b) 6 | No | Good function |
MRI: diffuse frond-like, fat-containing lesion involving the bicipitoradial bursa, lipoma arborescens arising from the bicipitoradial bursa was offered | |||||||
Doyle et al. [25] | 1 | Elbow (antecubital fossa) | Xray: no | Open excisional biopsy | 12 | No | Diminished pain |
MRI: lobulated mostly fatty mass anterior to the elbow joint and wrapping around the distal biceps tendon | |||||||
Kaneko et al. [24] | 1 | Shoulder (subdeltoid) | Xray: increased soft tissue | Open excisional biopsy and supraspinatus tear open repair | 40 | No | Full ROM. Residual pain |
MRI: villous mass with surrounding synovial fluid in sub-deltoid bursa FT tear ST. Enormous bursa | |||||||
Levadoux et al. [23] | 1 | Elbow (anterolateral mass) | Xray: normal | Open excisional biopsy | 48 | No | Full ROM. Asymptomatic |
MRI: joint effusion and synovial-based soft tissue mass. Numerous frond-like projections | |||||||
Nisolle et al. [22] | 1 | Shoulder (subdeltoid, subacromial) | Xray: soft tissue swelling | Open bursectomy and RC repair | 12 | No | Full ROM. Diminished pain |
MRI: full-thickness tear of the supraspinatus tendon and a large effusion within the bursa containing numerous frond-like projections |