Intraoperative Discovery of Lymphoma in the Knee During a Total Knee Arthroplasty: A Case Report

TL;DR

A patient undergoing knee surgery had a cancerous tumor discovered during the operation, leading to a change in treatment plan.

Contribution

Highlights the importance of considering malignancy when intraoperative pathologic fractures are found.

Findings

A pathologic fracture during surgery revealed diffuse large B-cell lymphoma.

Surgery should be stopped to investigate possible malignancy in such cases.

Intraoperative findings can significantly alter the treatment approach.

Abstract

A 67-year-old male with a past medical history of coronary artery disease, hypertension, and obesity presented with severe left knee pain and severe tricompartmental osteoarthritis. After failing conservative treatments and completing a preoperative medical workup, the patient was scheduled for total knee arthroplasty. Intraoperatively, a pathologic fracture of the distal femur was discovered, and the procedure was aborted. Histopathologic evaluation of the femur fracture revealed diffuse large B-cell lymphoma. Intraoperative discovery of a pathologic fracture should be treated as an underlying malignancy until proven otherwise. In these cases, surgery should be aborted until definitive diagnosis and management can be planned.

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