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Hypertrophy of the Faciae Latae: A Pseudotumor of the thigh

Abstract

Jiménez Hidalgo P J*, Calvo Haro J A, Mediavilla Santos L, Pérez Mañanes R, Cuervo Dehesa M, Llarena Barroso C

Introduction: Although trochanteric pain is a common entity, unilateral hypertrophy of
the Tensor Fasciae Latae (TFL) is a very rare condition, with few descriptions published.
We report our experience with two patients with unilateral hypertrophy of the TFL
muscle as a differential diagnosis of a tumor-like soft tissue mass on the thigh.
Materials and Methods: Case A: 51-year-old woman, consulting for long evolution left
hip pain associated with a soft tissue tumor on the proximal thigh, without growth on
the last year.
Magnetic Resonance Image (MRI): Tensor fasciae latae hypertrophy, associated with
atrophy of gluteus muscles and degenerative changes on the coxo-femoral joint. Case
B: 69-year-old woman without medical history of interest, consulting for swelling on
the left anterior thigh, associated with local pain and growth in the last 3,4 months.
TFL muscle hypertrophy, with higher volume compared to contralateral site, without
any difference on structure, not lipomatous infiltration or any other. Not pathologic
images found. Ultrasonography The structure is the same echogenicity of muscle
fibers, without any increased flow on Doppler images. It suggests a pseudotumor
based on hypertrophy of the fasciae latae muscle.
Results: Both patients were treated with conservative treatment and clinical
observation.
Conclusion: Hypertrophy of the tensor fasciae latae is a rare, benign clinical entity, with
soft tissue swelling on the anterolateral proximal thigh. Its etiology has been associated
with gluteus disfunction, but it may also correlate with other pathologies with TFL
over-activation, such as hip joint osteoarthritis or ACL injury. The main diagnostic tool
seems to be the MRI, and best treatment could associate clinical observation with
regular hip abductor training.

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