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Srpski arhiv za celokupno lekarstvo 2016 Volume 144, Issue 11-12, Pages: 650-653
https://doi.org/10.2298/SARH1612650S
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Atypical, polyarticular lipoma arborescens in a child

Semnic Robert (Vojvodina Oncology Institute, Sremska Kamenica + Medical Faculty, Novi Sad)
Simić Radoje (Mother and Child Health Care Institute of Serbia “Dr Vukan Čupić”, Belgrade + School of Medicine, Belgrade)
Đuričić Slaviša (Mother and Child Health Care Institute of Serbia “Dr Vukan Čupić”, Belgrade + University of Banjaluka, Faculty of Medicine, Banja Luka, Republic of Srpska, Bosnia and Herzegovina)
Ađić Oto (Vojvodina Oncology Institute, Sremska Kamenica)
Vanhoenacker Filip (AZ Sint-Maarten Duffel-Mechelen, Department of Radiology, Mechelen, Belgium + Antwerp University Hospital, Department of Radiology, Edegem, Belgium + University of Ghent, Faculty of Medicine and Health Sciences, Ghent, Belgium)

Introduction. Lipoma arborescens is a rare, tumor-like lesion commonly involving synovial joints and less commonly bursae and synovial tendon sheaths. Case Outline. We report a case of a 12-year-old boy with symmetric involvement of the bicipitoradial bursae, synovial sheaths of extensor compartments of both hands and medial ankles. The diagnosis of polyarticular lipoma arborescens was proposed on magnetic resonance (MR) imaging and this diagnosis was histologically proven after biopsy of the bursae and later by open surgery of the synovial sheath of the right ankle tendons. Literature search was performed and twelve cases with polyarticular involvement were analyzed. Lipoma arborescens commonly involves suprapatellar recess of the knee and very rarely other joints or bursae. Histological analysis revealed an accompanying non-necrotizing granulomatous synovial inflammation. Conclusion. Polyarticular lipoma arborescens is a rare entity and symmetrical involvement of the joints other than the knees is exceedingly rare. MR imaging plays a significant role in the diagnostic protocol, and the characteristic fatty signal on MR imaging is highly suggestive of lipoma arborescens.

Keywords: lipoma arborescens, synovium, tendon, MR imaging