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Large Parosteal Lipoma without Periosteal Changes.

Shimpo Aoki1, Tomoharu Kiyosawa1, Eiko Nakayama1

  • 1Department of Plastic and Reconstructive Surgery, National Defense Medical College, Tokorozawa, Japan.

Plastic and Reconstructive Surgery. Global Open
|February 13, 2015
PubMed
Summary

Parosteal lipoma is a rare tumor. This case highlights the largest parosteal lipoma of the femur without periosteal changes, emphasizing the need for accurate diagnosis and surgical planning.

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Area of Science:

  • Orthopedic Oncology
  • Surgical Pathology
  • Radiology

Background:

  • Parosteal lipoma is a rare benign tumor, representing about 0.3% of all lipomas.
  • Differential diagnosis from malignant tumors is crucial due to frequent association with bony lesions (59.2%).

Observation:

  • A 64-year-old male presented with a rapidly growing 25x15 cm right thigh mass.
  • MRI revealed a femur-based lesion with specific signal intensities, but no significant bony changes.
  • Surgical resection confirmed an 18x13x6 cm parosteal lipoma directly continuous with the femur.

Findings:

  • Pathological diagnosis confirmed lipoma, consistent with prior biopsy.
  • This represents the largest reported parosteal lipoma of the femur lacking periosteal changes.
  • Rapidly growing deep parosteal lipomas with ossification or chondromatous changes may indicate malignancy.

Implications:

  • Preoperative biopsy is mandatory for deep parosteal lipomas to rule out malignancy.
  • Accurate diagnosis and surgical planning are essential for appropriate treatment, avoiding overtreatment or undertreatment.
  • Plastic surgeons must consider parosteal lipoma in the differential diagnosis of rapidly growing thigh masses.