Soft tissue lipoma - thigh

Case contributed by Ammar Haouimi
Diagnosis almost certain

Presentation

Painless swelling at the lateral aspect of the distal left thigh.

Patient Data

Age: 70 years
Gender: Male
ultrasound

A relatively well-encapsulated mass iso to slightly hyperechoic to the subcutaneous fat with linear internal echogenic strands. No calcification or cystic component is seen.

ct

Large well-defined soft tissue mass of fat density (-115HU) with thin septations involving the lateral aspect of the distal thigh with deep extension in contact with the biceps femoris muscle (short and long head). No intra or intermuscular extension. No calcification or enhancing component.

Case Discussion

The ultrasound and CT features are most consistent with a soft tissue lipoma.

The main differential diagnosis is a low-grade liposarcoma which is difficult to differentiate from a lipoma and can have a relatively benign clinical course but suffers from a high rate of recurrence. For more details, please refer to the article: lipoma vs well-differentiated liposarcoma.

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