PMC6588136_01
(a) Lateral, (b) anterior, and (c) transversal views of magnetic resonance imaging using gadolinium-based contrast medium.
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F1
H and E staining for transoperatory incisional biopsy.
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F2
H and E staining (Fig. 2) yielded the following description: Lesion consisting of vacuolated and hyperchromatic large nucleus spindle cells, which are arranged in bundles that interlace with each other with densely cellular and collagenized areas; no abnormal mitotic activity is observed.
Immunohistochemistry staining for (a) PS100, (b) CD34, (c) EMA, and (d) GFAP antibodies.
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F3
Surgical excision of the neoplasm: (a) Anterior knee approach and (b) Hoffa's fat pad wide resection.
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F4
Hence, the patient underwent to surgical resection of the mass (measuring 2.3 cm, in its longest axis) -illustrated in Figs. 4 and 5-; in brief, the neuroma was resected by an anterior approach of the knee, performing a dissection in planes, until Hoffa's fat was localized.
(a) Real-time -i.e., fresh- external surface of Hoffa's fat pad and (b) fixed -10% paraformaldehyde buffer- and stained tissue for margin delimitation.
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F5
Hence, the patient underwent to surgical resection of the mass (measuring 2.3 cm, in its longest axis) -illustrated in Figs. 4 and 5-; in brief, the neuroma was resected by an anterior approach of the knee, performing a dissection in planes, until Hoffa's fat was localized.
H and E staining for definite excisional diagnosis.
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F6
Prior diagnosis was confirmed by histopathological examination(Fig. 6)altogether with clear margins from adjacent tissues: dermis, deep dermis, tendinous and rotula -both superior and inferior- fragments with no sign of lesion.
Postsurgical clinical evolution of the knee: (a) 1 day, (b) 1 week, (c and d) 2 weeks, (e) 3 weeks, and (f) 1 month after intervention.
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F7
At the moment (i.e., 6 months after surgery), the patient has recovered as expected, regained almost full function of the knee and quadriceps (Fig. 7) and has no alterations in the biomechanics of the knee nor pain.