Presentation
Leg pain, ultrasound identified an intramuscular lesion with feeding vessel, to rule out neoplastic etiology. Unremarkable lower limb arterial and venous doppler study
Patient Data
A fairly well defined spindle shaped lesion with thin fairly well defined margins is seen within the substance of vastus medialis.
The lesion is of homogeneous signal morphology with a linear band of longitudinal muscle fiber along with a vessel traversing the periphery of the lesion.
It is homogeneously hyperintense on T1 with uniform signal suppression in post contrast study. There is no irregular thickened septae or enhancing solid components.
Case Discussion
Morphologically intramuscular lipomas like to conform to the shape of the muscle and with active muscle contraction, likes to interdigitate between the fibers. However in the absence of any usual suspicious signs in this case, this is probably a benign intramuscular lipoma. Additional fibrous, muscular and vascular components may be accompanying these lesions apart from the uniform fat component, and it is important to evaluate them to rule out malignant transformation.
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