Intraosseous lipoma

Q: Where is the lesion? show answer

A: In the intertrochanteric region of the left femur.

Q: How would you describe its appearance? show answer

A: Predominantly radiolucent, with some coarse trabeculae or septae, and focal sclerosis at its distal border.

Q: Does this lesion seem agressive or rapidly growing? show answer

A: On the contrary. Sharp borders and rim sclerosis indicate a benign lesion.

Q: What further studies do you recommend to secure the nature of the lesion? show answer

A: MRI or CT.

Q: What is the final diagnosis? show answer

A: Intraosseous lipoma.

Q: How can these lesions be categorised? show answer

A: According to the Milgram classification. Type 1: sharply delineated, viable lipomas with homogeneous fat content Type 2: predominantly fatty lesions with central necroses, calcifications or ossifications Type 3: heterogeneous, fat-containing lesions with multiple necroses, cystic transformations, wall sclerosis, and extensive calcifications or ossifications.

Q: Where are intraosseous lipomas most frequently found? show answer

A: Most are in the lower limb (71%) with the most common locations being the calcaneum (32%) and the femur (20% - especially the intertrochanteric region).