Symptomatic Intraosseous Lipoma of the Calcaneum

Intraosseous lipomas are rare bone lesions that can affect any part of the skeleton. In the calcaneum, they are, generally, asymptomatic, but in some cases, patients may complain of pain, swelling or tenderness. Well-conducted radiography and MRI examinations can lead to an accurate diagnosis. In most cases, patients could benefit from conservative means of treatment, but in long-lasting symptomatic cases, surgical treatment may be a good option. The purpose of this article is to increase clinicians’ awareness of this lesion as a possible cause of heel pain and to describe a case of a symptomatic intraosseous lipoma of the calcaneum who underwent curettage and bone cement filling after failure of conservative treatment.

U mỡ trong xương bướm: một trường hợp hiếm gặp

TÓM TẮT U mỡ trong xương là khối u lành tính hiếm gặp, thường gặp ở các xương dẹt, hiếm gặp ở xương nền sọ, đặc biệt là xương bướm. Trong đa số các trường hợp, u mỡ trong xương bướm thường được phát hiện tình cờ qua chụp cắt lớp vi tinh (CLVT) hoặc cộng hưởng từ (CHT) sọ não. Đây là một khối u phát triển chậm, ít gây ra triệu chứng, một số trường hợp gây triệu chứng khi khối u to chèn ép vào cấu trúc lân cận như tuyến yên hoặc dây thần kinh thị. Trong bài này, chúng tôi báo cáo một trường hợp u mỡ trong xương bướm không triệu chứng được phát hiện tình cờ và được chẩn đoán dựa vào phim chụp cộng hưởng từ sọ não. Bệnh nhân được khuyến nghị theo dõi định kỳ bằng cộng hưởng từ mà không phải tiến hành bất kỳ phương pháp điều trị nào. Từ khóa: U mỡ, xương bướm, MRI, cộng hưởng từ sọ não, chẩn đoán hình ảnh. ABSTRACT INTRAOSSEOUS LIPOMA OF SPHENOID BONE: A RARE CASE REVIEW Intraosseous lipoma is very rare, usually benign tumor of flat bones. The incidence of an intraosseous lipomalocated basal skull bones is extremely rare, especially in sphenoid bone. Radiological imaging techniques such as magnetic resonance imaging (MRI) and computed tomography (CT) are used to detect the intraosseous lipoma by accident. These tumors are slow growing and usually asymptomatic, in some cases causing symptoms when the large tumor presses on nearby structures such as pituitary gland or the optic nerve. We present a rare case of lipomaof the sphenoid bone discovered incidentally with brain magnetic resonance imaging. The patient has been followed-up by magnetic resonance imaging without the need for surgery. Keywords: Intraosseous lipoma, sphenoid bone, MRI, brain MRI, diagnostic radiology

Clinicoradiographic Features and Histopathologic Variations of Intraosseous Lipoma: Report of a Case and Review of the Literature

Intraosseous lipoma is a very rare lesion, and the jaw is its least common bone location. Fibrolipoma is a microscopic variant of lipoma which is characterized by a significant fibrous component intermixed with lobules of fat cells. Intraosseous fibrolipoma of the jaw is a rare lesion, and to the best of our knowledge, only two cases have been reported from 1948 in English literature. This paper presents a 39-year-old man with a chief complaint of tooth displacement in the anterior region of the mandible. Radiographic evaluation revealed a unilocular radiolucent lesion with sclerotic borders located between the left lateral incisor and canine. Histopathologic evaluation after an excisional biopsy confirmed the diagnosis of intraosseous fibrolipoma. We also reviewed the literature on this rare lesion.

A rare case of intraosseous lipoma of distal tibia – A case report and review of literature

Introduction: Intraosseous lipoma is a very rare neoplasm accounting for < 0.1 % of primary bone tumors. Pain is the leading symptom in majority of the reported cases but it can be asymptomatic. There is slight male predominance in occurrence of this lesion. The plain radiological findings are not specific and requires differential diagnosis. The lesion is mostly diagnosed by histopathological examination. Case report: A 31-year-old male presented with localized pain around the medial aspect of right ankle joint for one week. Examination revealed mild tenderness over the distal part of the right tibia over the medial aspect. Plain radiograph of the right leg showed well-defined expansile osteolytic lesion with sclerotic rim and calcified matrix at metaphysis of distal tibia. MRI showed enhancing T1-weighted hypo intense and T2-weighted hyperintense lesion. For this case, radiological impression was giant cell tumor with differential diagnosis of aneurysmal bone cyst and fibrous dysplasia. However, the histopathological examination showed intraosseous lipoma, consistent with stage II of Milgram’s classification. Conclusions: Although the diagnosis of intraosseous lipoma can be very challenging due to its rarity and indistinct plain radiograph findings, combination of computed tomography or magnetic resonance imaging may be useful by being able to show the presence of fat within the lesion. However, the clinicians, surgeons and radiologist should be familiar and be aware of these findings to be able to come to a correct diagnosis since not all cases need surgery and can be managed conservatively.