Presentation
Left hip pain
Patient Data
A well defined minimally expansile inhomogeneous lucent lesion with narrow transitional zone is seen centered in the intertrochanteric region/proximal metaphysis of the left femur. No definite extra-osseous soft tissue component. No other gross abnormality seen.
Findings suggestive of a benign looking lesion like aneurysmal bone cyst or liposclerosing myxofibrous tumor.
A well defined bony lesion measuring approximately 10 x 5 cm is seen centered in the intertrochanteric region/proximal metaphysis of the left femur that shows isointense signal in T1 with tiny foci of high signal seen within the lesion, suggestive of tiny fat component and heterogeneous with areas of intense bright signal in T2 that could represent myxoid component. No fluid-fluid levels or extra osseous soft tissue component. No other gross abnormality seen.
Findings suggestive of liposclerosing myxofibrous tumor.
Case Discussion
Liposclerosing myxofibrous tumor is a rare benign fibro-osseous lesion that have a predilection for the intertrochanteric region of the femur.
Common in males with mean age of 30-40 years. It can be discovered incidentally, but most patients have vague pain. 10% of patients may present with pathological fracture.
The tumor comprises of mixture of tissues of lipomatous, fibroxanthomatous, mxomatous and myxofibromatous components.
Malignant transformation to osteosarcoma is 10-15%, so the lesion needs follow up imaging preferably by MRI. symptomatic lesions or those with interval change require surgical resection.
Differential diagnosis:
Fibrous dysplasia, aneurysmal bone cyst, intra osseous lipoma.
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