Posterior Knee Mass; Is It A Tumor?

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Posterior Knee Mass; Is It A Tumor? - Page #4

Working Diagnosis: Benign neurofibroma Treatment: Conservative treatment with observation, pain management via over-the-counter medications as needed, and continuation of running as pain allowed. Outcome: Conservative treatment including watchful waiting was chosen, given the benign pathology of the lesion. Patient is to have follow up MRI in approximately one year to reassess the lesion. Patient was able to continue running with minimal symptoms. Author's Comments: Neurofibromas are benign tumors of the peripheral nerve sheath. These tumors often present in young patients between 20 and 30 years of age. Approximately 90% are not associated with syndromes such as NF1. Evaluation of lesions is most efficiently done using MRI with contrast. Management of solitary cutaneous neurofibromas should be conservative. Surgery should not be performed unless there is significant untreatable pain, suspicion for malignancy, interference with function, or disfigurement. Observation is appropriate unless the patient has progressing neurologic deficits or significantly increasing pain. Editor's Comments: Ultrasound can be used to evaluate masses in the popliteal region, but not all are amenable to aspiration. Neurofibromas are important to remember in the differential of any soft tissue mass; as the author points out, most are not associated with a syndrome. References: UpToDate Peripheral Nerve Tumors. https://www.uptodate.com/contents/peripheral-nerve-tumors?search=benign%20neurofibroma&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1 Return To The Case Studies List.		Back
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