Leg pain, ultrasound identified an intramuscular lesion with feeding vessel, to rule out neoplastic etiology. Unremarkable lower limb arterial and venous doppler study
Contrast enhanced MRI of thigh
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A fairly well defined spindle shaped lesion with thin fairly well defined margins is seen within the substance of vastus medialis.
The lesion is of homogeneous signal morphology with a linear band of longitudinal muscle fibre along with a vessel traversing the periphery of the lesion.
It is homogeneously hyperintense on T1 with uniform signal suppression in post contrast study. There is no irregular thickened septae or enhancing solid components.
Morphologically intramuscular lipomas like to conform to the shape of the muscle and with active muscle contraction, likes to interdigitate between the fibres. However in the absence of any usual suspicious signs in this case, this is probably a benign intramuscular lipoma. Additional fibrous, muscular and vascular components may be accompanying these lesions apart from the uniform fat component, and it is important to evaluate them to rule out malignant transformation.
- Matsumoto K, Hukuda S, Ishizawa M, Chano T, Okabe H. MRI findings in intramuscular lipomas. Skeletal radiology. 1999 Mar 1;28(3):145-52.
- Kransdorf MJ, Bancroft LW, Peterson JJ, Murphey MD, Foster WC, Temple HT. Imaging of Fatty Tumors: Distinction of Lipoma and Well-differentiated Liposarcoma1. Radiology. 2002 Jul 1.