Abstract
A case of 16 yrs male patient with parosteal lipoma affecting the lower metaphyseal end of the left femur is presented. Clinical suspicion, plain radiographs, CT (Plain and 3 D) as well as MRI suggested a diagnosis of parosteal lipoma. Lipomas may be defined as benign lesions of mature adipose tissue without evidence of cellular atypia [1]. Lipomas are the most common soft tissue lesions and surprisingly are among the rarest bone neoplasias. The most frequent complaints are a tumoral convexity presenting as a visible or palpable mass or a mild-intensity, dull pain. The parosteal type is a rare tumor accounting for 0.3% of all lipomas [2] and is usually asymptomatic. It is seen commonly affecting adults aged over 40 [3]. The present article describes a rare case of parosteal lipoma located in the femur, with extensive hyperostosis visible on plain xray and confirmed by imaging studies (CT and MRI). Unlike the parosteal lipomas reported in adults over 40 yrs in this case it presented in a much younger age group.
Highlights
A case of 16 yrs male patient with parosteal lipoma affecting the lower metaphyseal end of the left femur is presented
The clinical evaluation revealed a nonpulsatile mass in the anteromedial face of the distal two-thirds of the left thigh that had a tender consistency and regular contour adhered to the deeper planes
Computed tomography of the left thigh showed a heterogeneous calcification image in the periosteal topography located in the medial region of the distal third of the femur in the meta-diaphyseal junction
Summary
A 16 year-old male patient noticed an increase in the volume of his Left thigh with dull aching pain, approximately 2 years ago. The clinical evaluation revealed a nonpulsatile mass in the anteromedial face of the distal two-thirds of the left thigh that had a tender consistency and regular contour adhered to the deeper planes. Conventional radiographs of the left thigh showed the presence of a spiculated periosteal bone formation in the antero medial face of the distal region of the femur and an increase in the amount of soft tissue with a radio density characteristic of fatty tissue (radiolucent image) (Figure 1) [4]-[6]. To characterize the lesion and define the compression of adjacent neurovascular bundle, magnetic resonance imaging (MRI) was performed [7] It revealed a well-defined, multilobulated, and juxtacortical bony excrescence measuring 8 × 4.7 cm in size at the lower end of the left femur. After 15 months follow up the patient had no complaints and had normal range of movements at the knee
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