Presentation
Painless palpable swelling at the medial thigh. She reported having felt it first one year ago.
Patient Data
A well-defined solid lesion is seen within the sartorius muscle.
It is relatively hyperechoic to adjacent musculature.
Linear echogenic internal strands are seen that are parallel to the skin.
No calcification or cystic changes.
The ipsilateral great saphenous vein is seen coursing superficial to the mass.
The mass is seen within the muscle with well-defined margins and a relative increase in echogenicity. The great saphenous vein as demonstrated is seen just superficial to the mass.
Case Discussion
Intramuscular lipomas account for only 1% of all lipomas and have been known to occur in the 5th-7th decades of life with a slight female predominance. While they can occur anywhere, most cases involve muscles of the trunk and extremity.
Interdigitations of muscle tissue within the mass cause the characteristic striated appearance which is a highly specific diagnostic clue. Lack of calcifications, cystic changes, and internal arterio-venous flow should be documented as these could suggest liposarcomatous transformation.
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