Clinical History
This 50-year-old patient presented with a chronic lateral upper thigh mass which appeared to arise from the tensor fascia lata. The patients past medical history was significant for lumbar radiculopathy. At the time of surgery the mass lesion appeared to be composed of skeletal muscle. A biopsy was performed.
What is your diagnosis based on the provided frozen section H&E, modified Gomori Trichrome, esterase and myosin heavy chain fast (MHCf)?
Correct Answer:
The images show pathologic alterations of denervation with some background mild myopathic changes. In the context of this patient’s clinical history the findings are consistent with neurogenic hypertrophy.
Neurogenic hypertrophy occurring in the tensor fascia lata as a mass lesion has been previously reported.
References/Additional Readings:
- Shields LBE, Iyer V, Bhupalam RC, Zhang YP, Shields CB. Hypertrophy of the tensor fascia lata: A pseudotumor due to lumbar radiculopathy. Surg Neurol Int. 2021 Oct 19;12:522. doi: 10.25259/SNI_857_2021. PMID: 34754572; PMCID: PMC8571211.
- Strano CM, Bosco L, Laurini C, Sferruzza G, Butera C, Falzone YM, Sorrenti B, Ratti A, Tufano L, Leonardi L, Merlonghi G, Morino S, Gerevini S, Del Carro U, Garibaldi M, Filippi M, Previtali SC. Muscle hypertrophy following acquired neurogenic injury: systematic review and analysis of existing literature. Ann Clin Transl Neurol. 2024 Aug;11(8):2123-2137. doi: 10.1002/acn3.52133. Epub 2024 Jun 21. PMID: 39030749; PMCID: PMC11330231.
- Gutmann L. AAEM minimonograph #46: neurogenic muscle hypertrophy. Muscle & Nerve, 1996: 19: 811-818
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