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Intramuscular lipoma - foot

Case contributed by Maulik S Patel
Diagnosis almost certain

Presentation

Right mid-foot dorsum lump for a few years. Recent mild local discomfort.

Patient Data

Age: 45 years
Gender: Female
ultrasound

A well-defined lesion with echogenic striations with mild compressibility. No internal calcification/ cystic changes/ vascularity. It measures about 43 x 26 x 10 mm. The extensor hallucis brevis muscle lies on the medial side of the lesion, with its rim covering the anterior of the lesion favoring the intramuscular lesion location (claw sign). The extensor digitorum brevis muscle is normal and lies on the lateral side of the lesion. The extensor digitorum longus tendons pass superficial to the lesion. The patent dorsalis pedis artery lies medial and deep to the lesion.

x-ray

Dorsal mid-foot bulge with fat density. Normal bones and joints.

Case Discussion

The foot dorsum lump shows ultrasound features of a lipoma. A claw sign favors intramuscular location involving the extensor hallucis brevis muscle.

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