Morel-Lavallee Lesion in the Upper Extremity

Hand (N Y). 2017 Jan;12(1):NP10-NP13. doi: 10.1177/1558944716646776. Epub 2016 Aug 24.

Abstract

Background: The Morel-Lavallee lesion (MLL) is a closed internal degloving injury that results from shearing of the skin and subcutaneous tissue from the underlying fascia. Disruption of the perforating blood vessels and lymphatics results in a lesion filled with serosanguinous fluid and necrotized fat. MLLs are most commonly described in association with pelvic and lower extremity trauma, and there are limited reports of these lesions in other locations. Methods: This case report describes a 58-year-old male referred from his primary care physician with a soft tissue mass in the upper arm. Careful history discovered prior trauma with extensive bruising and MRI revealed a large encapsulated mass consistent with MLL. Results: An open debridement with excision of pseudocapsule was performed. Meticulous closure over a drain was performed and the patient healed without complication or recurrence. Intra-operative cultures were negative and pathology was consistent with MLL. Conclusion: MLL should always be considered in the setting of previous trauma regardless the location. In the chronic setting an open approach with excision of pseudocapsule can have an acceptable result.

Keywords: Lavallee; Morel; cyst; internal degloving; soft tissue mass.

Publication types

  • Case Reports

MeSH terms

  • Accidents, Traffic
  • Arm Injuries / diagnostic imaging*
  • Arm Injuries / surgery
  • Cysts / diagnostic imaging
  • Cysts / surgery
  • Debridement / methods
  • Degloving Injuries / diagnostic imaging*
  • Degloving Injuries / surgery
  • Humans
  • Magnetic Resonance Imaging / methods
  • Male
  • Middle Aged
  • Subcutaneous Tissue / diagnostic imaging
  • Subcutaneous Tissue / injuries*
  • Subcutaneous Tissue / surgery