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Aoki S, Kiyosawa T, Nakayama E, et al. Large Parosteal Lipoma without Periosteal Changes. Plast Reconstr Surg Glob Open. 2015;3(1):e287doi: 10.1097/GOX.0000000000000254.
Aoki, S., Kiyosawa, T., Nakayama, E., Inada, C., Takabayashi, Y., Sumi, Y., Doumoto, T., Aizawa, T., & Azuma, R. (2015). Large Parosteal Lipoma without Periosteal Changes. Plastic and reconstructive surgery. Global open, 3(1), e287. https://doi.org/10.1097/GOX.0000000000000254
Aoki, Shimpo, et al. "Large Parosteal Lipoma without Periosteal Changes." Plastic and reconstructive surgery. Global open vol. 3,1 (2015): e287. doi: https://doi.org/10.1097/GOX.0000000000000254
Aoki S, Kiyosawa T, Nakayama E, Inada C, Takabayashi Y, Sumi Y, Doumoto T, Aizawa T, Azuma R. Large Parosteal Lipoma without Periosteal Changes. Plast Reconstr Surg Glob Open. 2015 Feb 06;3(1):e287. doi: 10.1097/GOX.0000000000000254. eCollection 2015 Jan. PMID: 25674368; PMCID: PMC4323391.
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Plast Reconstr Surg Glob Open. 2015 Feb 06;3(1):e287. doi: 10.1097/GOX.0000000000000254. eCollection 2015 Jan.

Large Parosteal Lipoma without Periosteal Changes.

Plastic and reconstructive surgery. Global open

Shimpo Aoki, Tomoharu Kiyosawa, Eiko Nakayama, Chiaki Inada, Yuki Takabayashi, Yuki Sumi, Takashi Doumoto, Tetsushi Aizawa, Ryuichi Azuma

Affiliations

  1. Department of Plastic and Reconstructive Surgery, National Defense Medical College, Tokorozawa, Japan.

PMID: 25674368 PMCID: PMC4323391 DOI: 10.1097/GOX.0000000000000254

Abstract

Parosteal lipoma is a rare tumor, accounting for approximately 0.3% of all lipomas. Bony lesions are often found in patients with this tumor (59.2%), making the differential diagnosis of malignant tumors important. Our case was a 64-year-old male patient who complained of a 25 × 15-cm mass on his right thigh that had grown rapidly over a 2-month period. On magnetic resonance imaging, a high-intensity lesion was observed on the surface of the femur beneath the vastus medialis muscle on T1 and T2 images, with low intensity on a T1 fat suppression image. No significant bony changes were detected. During total tumor resection, the tumor was found on the femur with tight continuity, with tiny areas of spiculation palpable on the bone surface. The exact tumor size was 18 × 13 × 6 cm. The pathological diagnosis was lipoma, the same result as in the former open biopsy. This case was the largest parosteal lipoma of the femur reported without periosteal changes. In cases of deep parosteal lipomas, the detection of rapidly progressive and growing pseudotumors with ossification or chondromatous changes implies malignancy. A preoperative biopsy is mandatory and must be followed by careful planning and preparation for handling in malignant cases. Plastic surgeons should therefore keep the diagnosis of parosteal lipoma in mind to provide appropriate (not too much or too little) surgical treatment.

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