Fibrous xanthoma - proximal femur (probable)

Case contributed by Dr Varun Babu

Presentation

Left renal colic for evaluation. Negative KUB sonography.

Patient Data

Age: 25 years old
Gender: Male

CT abdomen and pelvis

CT

Well defined lytic lesion of maximal diameter 2.5 cm is seen epicentered in the posterior cortex of right femur neck extending into the medullary cavity causing mild cortical scalloping. No cortical breach. Dense uniform peripheral sclerosis with narrow zone of transition indicative of benign nature. No accompanying periosteal reaction. 

Case Discussion

The morphological features point towards a benign lesion which is clinically asymptomatic. The cortical based location with the age of presentation favors the possibility of a fibrous xanthoma. The age of patient favors a diagnosis of non ossifying fibroma rather than a fibrous cortical defect. 

Fibrous xanthomas are 'DO NOT TOUCH' lesions and should be left alone and do not need further workup. 

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