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Skull base intraosseous lipoma

Case contributed by Aliaa Ghoneim
Diagnosis almost certain

Presentation

Chronic headaches.

Patient Data

Age: 55 years
Gender: Female

There is a fat density lucent lesion within the left sphenoid bone. It has a narrow zone of transition with no cortical breakthrough or soft tissue component. It shows internal septations and residual bone trabeculations within. The appearance is that of a benign long-standing lesion most in keeping with an intraosseous lipoma.

The left sphenoid bone lesion shows high signal intensity on all sequences with no enhancement on post-contrast images.

Case Discussion

This patient presented with chronic headaches and was found to have this incidental left sphenoid bone lesion. It characteristically contains fat and has all features to suggest a benign bone lesion. Intraosseous lipomas usually show internal septations and residual bone marrow trabeculations within. Skull base lipomas, however, don't always show central calcifications as the extremity ones do. 

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