J Korean Bone Joint Tumor Soc.  2012 Dec;18(2):104-108. 10.5292/jkbjts.2012.18.2.104.

Parosteal Lipoma of the Femur with Hyperostosis: A Case Report

• Kim DY
• Jeon HS
• Jeon SJ
• Noh HK
• Kang SG
• Song JU
• Park BM

• KMID: 1431679
• DOI: http://doi.org/10.5292/jkbjts.2012.18.2.104

Abstract

Parosteal lipoma is a rare kind of lipoma that occurring adipous tissue around the periosteum. It has been reported most commonly in the femur, the radius, the tibia and the fibular. Treatment consists of resecting the lipomatous tumor with further exeresis of the bone and periosteal excrescence in cases with hyperostosis. The authors report a rare case of parosteal lipoma occurring at the medial portion of the femur shaft with a review of the relevant literatures.

Keyword

femur; parosteal lipoma; hyperostosis

MeSH Terms

Femur
Hyperostosis
Lipoma
Periosteum
Radius
Tibia

Figure

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  Figure 1 Plain radiography: anterior view of the distal third of the right femur showing exuberant periosteal reaction in the medial cortical area associated with an increase of adjacent radiolucent soft parts (density of fatty tissue).

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  Figure 2 (A) An ear-shape increased tracer uptake area arising from the periosteum of the right lower medial femoral shaft. (B) The pinhole scan reveals the uptake to consist of speckled high uptake areas.

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  Figure 3 Computed tomography: Window of soft parts where an intramuscular expansive process can be seen around the femur, with the radiodensity of fat. And in the mass, partial overgrowing of cortical bone and seafood like bone forming calcifications are seen. Note the hyperostosis in the cortical medial area of the bone without medullary invasion and infiltrative appearance.

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  Figure 4 Magnetic resonance image: Under the intermediate vastus medialis muscle, the tumor mass is seen. The mass is attached to the femur cortex, and partial thickening of cortical bone is seen. And geographic irregular, hyposignal processes in T1 weight image is seen. Bone marrow involvement is not seen. And sharply defined capsule surrounding deep muscle is seen, too.

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  Figure 5 (A) Intraoperative photograph: yellowish, round shaped tumor attached to femur is seen. (B) The submitted specimen consists of a well demarcated fatty mass. (C) On section, it reveals yellow soft greasy fatty cut surface with some scattered bone spicules. And some crackled bone fragments, up to 1 cm, are also submitted.

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  Figure 6 Histologic findings of the parosteal lipoma. The lamellated mature bone surrounded by lipoma interposed with fibrous septa is shown. Adiposities were seen without cellular atypia (hematoxylin and eosin, ×200).

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