Table 1 Characteristic of other reviewed primary patellar tumors
Type | Symptoms | History | Clinical examination | Imaging | Laboratory test | Pathology | Treatment |
|---|---|---|---|---|---|---|---|
Lipoma [44] | - | - | - | R: a well-defined multilobulated lytic lesion replacing part of the patella | - | The specimen demonstrated a lobulated lesion | - |
Immediate pain and swelling of the affected knee after twisting it during a fall | Injury of history | A knee joint effusion, point tenderness, limited range of motion, severe pain on flexion-extension of the knee | R: a well-defined lytic lesion, a pathological fracture, joint effusion, lobulated margins, septa, sclerotic rim, thick trabeculae. BS: a focal solitary area of intense activity in the affected patella | - | A cyst-like lesion containing fibromyxoid and ‘fatty’-appearing material, a mild amount of chronic inflammatory cells and reactive bone | Immobilization to treat the pathological fracture (stage 3), curettage and allograft bone graft (stage 3), curettage (stage 1) | |
Osteitis fibrosa cystica [62] | - | A history of thyroid-related problems | - | R: osteitis fibrosa cystica with multiple irregular cystic areas | - | - | Excision of the lesion (stage 1) |
Leiomyosarcoma [64] | Patellar pain and swelling | Be treated with curettage and bone graft of the patella due to uncertain diagnosis | Swelling, local heat, elastic hard mass, decreased range of motion, thigh muscle atrophy | R: a mixed lytic and sclerotic lesion with ill-defined margin in the patella. CT: sclerotic rim and osteolytic lesion with cortical disruption. MRI: extraosseous high signal intensity infiltration on T2-weighted imaging. BS: isolated increased activity in the affected patella | WBC count, AP and CRP were within normal ranges | Fascicles of centrally spindle cells with blunt ended nuclei. The cells showed immunoreactivity for muscle-specific actin (HHF35) | Extra-articular wide resection with total patellectomy and reconstruction by Howmedica modified resection system (Stage IIIB) |
- | - | - | R: multicentric lesion, permeative bone with cortex destruction and ill-defined margins, joint involvement. CT: destroyed cortex and determination of the grade of the tumor. | - | - | Radiotherapy (stage IIB, IIIB) | |
- | - | - | R: a lobular contour with ill-defined margins, septation ‘soap-bubble appearance’, thinned and piercing cortex, mimicking giant cell tumor | - | - | Patellectomy (stage IB), radiotherapy (stage IA), patellectomy and radiotherapy (stage IA, IB) | |
CT: determination of radiographic findings and indication of multiple lesions. BS: Single increased activity in the affected patella. | |||||||
Ewing’s sarcoma [65] | Increasing patellar pain and swelling, limp, impairing function, atrophy of quadriceps, weight loss, night sweats | A motor vehicle accident some months prior | A warm and swollen knee, painful limitation of flexion, patellofemoral irritability at compression, | R: mass-like change, sclerosis, permeative change. MRI: marrow replacement by tumor in the patella, soft tissue mass, lesion of proximal tibial, widespread involvement of bone marrow in the vertebral bodies and sacrum epiphysis. CT: pulmonary metastases. | Straw-colored joint fluid with 850 white cells with 94% mononuclear predominance, increasing of ESR. | Extensive necrosis of the lesion, neoplasm composed of nests of small round cells, scant amphophilic cytoplasm, cytoplasmic glycogen (+), membranous CD99 (+), nuclear FLI-1 (+) | Chemotherapy (stage IIIB) |