Liposclerosing myxofibrous tumour

Liposclerosing myxofibrous tumours (LSMFT), also known as polymorphic fibro-osseous lesions of bone, are rare benign fibro-osseous lesions that have a predilection for the intertrochanteric region of the femur.

It is slightly more common in males with mean age of 30-40 years-old. It can be discovered incidentally but mostly patients have vague longstanding pain. About 10% of patients present acutely with pathologic fracture.

The tumour comprises of the wide mixture of tissues of lipomatous, fibroxanthomatous, myxomatous, and myxofibromatous components inclusive. 

Location

Tends to have a striking predilection for the intertrochanteric region of the femur (80-90%) 1-3.

Radiographs and CT 
  • geographic lucent lesion usually centred in intertrochanteric region of the proximal femur
  • sclerotic margin
  • mildly expansile
  • multilocular
  • matrix calcification in ~70% of cases
  • fat density component
MRI

Despite its name distinct fatty components are not seen

  • T1: relatively homogeneous and isointense to skeletal muscle
  • T2: moderately heterogeneous with areas of high signal due to myxoid component
Scintigraphy

Can show mild focal uptake with 99Tc 1.

  • pathological fracture: uncommon ~10%
  • malignant transformation: rare but documented 10-15%; transformation into osteosarcoma is the most common

Due to this potential malignant transformation, lesions need follow-up imaging preferably by MRI. Symptomatic lesions or those with interval change require surgical resection 3.

On radiographs consider:


Bone tumours

The differential diagnosis for bone tumours is dependent on the age of the patient, with a very different set of differentials for the paediatric patient.

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Article Information

rID: 9663
Section: Pathology
Tags: cases, refs
Synonyms or Alternate Spellings:
  • Liposclerosing myxofibrous tumour (LSMFT)
  • LSMFT

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    Case 1: in right femur
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