Intraosseous Lipoma: Report of 2 Cases

FCY Lam, JLY Leung, SJ Shu, ACL Chan, MK Chan, DHS Fung

Hong Kong J Radiol 2004;7:145-8

Intraosseous lipoma is a rare benign bone tumour. This report presents 2 cases of intraosseous lipoma: 1 occurring in the right intertrochanteric region of a 67-year-old man and 1 at the left distal fibula of a 72-year-old woman. For the first patient, the computed tomogram showed a radiolucent intramedullary lesion with a slightly lobulated sclerotic margin and homogeneous fat density; the T1-weighted magnetic resonance image showed hyperintensity in the area of the lesion, which could be fully subtracted in the fatsaturated sequence. This patient was followed up regularly and has shown no evidence of malignant change. For the second patient, the X-ray showed pathological fractures at the distal fibula and tibia; computed tomography revealed an intramedullary, slightly expansile, osteolytic lesion at the distal end of fibula, together with endosteal scalloping and a dense tumour matrix; and histological examination revealed that this lesion consisted of necrotic adipose tissue and extensive calcification. The lipoma was resected and has not recurred. Because the overall prognosis of intraosseous lipoma is good, we suggest that once the diagnosis is established by imaging or histological studies, conservative treatment with regular follow-up scanning should be considered for asymptomatic cases.