Abstract
Lipomas are benign tumors of mature adipose tissue which can occur in subcutaneous, intramuscular, intermuscular, parosteal, and intraosseous compartments. Parosteal lipoma is a rare type of lipoma, accounting for less than 0.1% of primary bone neoplasms and 0.3% of all lipomas. Parosteal lipomas commonly arise in the femur and extremities. Around 150 cases have been reported in English literature with scapula being a rare site of involvement. They are known to be associated with underlying bony changes like focal cortical hyperostosis, pressure erosion of the underlying bone, and bowing deformity or with underlying osteochondroma. We report a rare case of a parosteal lipoma arising in the scapula with a bony excrescence in a 38-year-old male.
Highlights
We report a rare case of a parosteal lipoma arising in the scapula with a bony excrescence in a 38-year-old male
Parosteal lipoma is a rare benign mesenchymal primary tumor arising from periosteum
Imaging plays an important role in diagnosis, characterization of the lesion with magnetic resonance imaging (MRI) evaluating the effect of the tumor on the neurovascular bundle and associated muscle atrophy
Summary
A 38-year-old male presented with complains of a painless swelling gradually increasing in size over the left side of upper back for 3 years. An approximately 6 × 5 cm sized mass was palpated adjacent to inferior margin of left scapula. Plain radiograph of left shoulder joint revealed an irregular osseous protuberance seen contiguous with inferior part of lateral border of left scapula with overlying wellcircumscribed radiolucent lesion (Figure 1). To characterize the lesion and define the compression of adjacent neurovascular bundle, plain and contrast enhanced magnetic resonance imaging (MRI) was performed on 3T Achieva Philips MRI scanner which revealed a well-defined, multilobulated, and juxtacortical bony excrescence measuring 2 × 1.7 cm in size adjacent to inferior margin of left scapula showing no contiguity with marrow space of scapula differentiating it from an osteochondroma. The patient refused complete excision of mass which is treatment of choice
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