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Beitragstitel Dupuytren-like fibromatosis of the acetabular labrum: a case report
Beitragscode P040
Autoren
  1. Monika Senftl HFR – Cantonal Hospital Fribourg Vortragender
  2. Sylviane Schobinger-Clément Institute of Pathology, Fribourg
  3. Edouard Stauffer ProMed medical laboratory SA
  4. Emanuel Gautier HFR Fribourg - Hôpital Cantonal
Präsentationsform Poster
Themengebiete
  • A04 - Hüfte
Abstract Introduction
Dupuytren’s disease is a fibro-proliferative disorder known to affect the palm of the hand. Other known superficial fibromatoses are Garrod's knuckle pads, plantar fibromatosis of Ledderhose, and Peyronie's penile fibromatosis. In frozen shoulder, joint capsulitis shows similar histological alterations to those in Dupuytren's disease. Such alterations never have been described to occur in the hip joint.

Case report
A 23 year old female patient presented with a 2-year history of progressive right hip pain, without prior history of trauma. She complained of a constant pain in the groin, episodes of pseudo-blockades, and joint stiffness with ambulation. Clinical examination revealed reduced flexion and internal rotation as well as significant pain during FADIR-testing. Standard radiographs did not show residual hip dysplasia nor signs of femoro-acetabular impingement.
Further investigation by MRI scan showed hypertrophic synovia at the antero-lateral femoral head-neck junction. The patient underwent surgical dislocation of the hip through a trochanteric slide approach with excision of a lobulated mass measuring 30x15x8 mm originating from the antero-superior acetabular labrum. Macroscopically, the articular cartilage and hip joint capsule were found to be normal. Postoperatively, the patient reported significant relieve of pain and functional recovery. MRI scan at 10 months showed no evidence of recurrence.

Histopathological workup
Multinodular proliferation of benign fibroblasts as well as myofibroblast proliferation was seen. The histological appearances were found to be similar to those in Dupuytren's disease of the hand, with no inflammation and no synovial involvement.

Conclusion
The described tumoral lesion of the acetabular labrum seems to belong to the group of Dupuytren’s fibromatosis. Due to its localization inside the hip joint it is diagnosed as Dupuytren-like fibromatosis. MRI is the method of choice for diagnosis and complete excision of the tumor including adjacent parts of the acetabular labrum may result in excellent outcome, without recurrence.